Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial.
Gerardo MalzoneGiulio MenichiniMarco InnocentiAlberto BallestínPublished in: Scientific reports (2023)
Technical advances in microsurgery have enabled complex oncological reconstructions by performing free tissue transfers, nerve and lymphatic reconstructions. However, the manual abilities required to perform microsurgery can be affected by human fatigue and physiological tremor resulting in tissue damage and compromised outcomes. Robotic assistance has the potential to overcome issues of manual microsurgery by improving clinical value and anastomoses' outcomes. The Symani Surgical System, a robotic platform designed for microsurgery, was used in this in-vivo preclinical study using a rat animal model. The tests included anastomoses on veins and arteries performed by microsurgeons manually and robotically, with the latter approach using Symani. The anastomoses were assessed for patency, histopathology, and execution time. Patency results confirmed that the robotic and manual techniques for venous and arterial anastomoses were equivalent after anastomosis, however, the time to perform the anastomosis was longer with the use of the robot (p < 0.0001). Histological analysis showed less total average host reaction score at the anastomotic site in robotic anastomosis for both veins and arteries. This study demonstrates the equivalence of vessel patency after microsurgical anastomoses with the robotic system and with manual technique. Furthermore, robotic anastomosis has proven to be slightly superior to manual anastomosis in terms of decreased tissue damage, as shown by histological analysis.
Keyphrases
- robot assisted
- minimally invasive
- oxidative stress
- endothelial cells
- clinical trial
- prostate cancer
- type diabetes
- internal carotid artery
- parkinson disease
- magnetic resonance imaging
- randomized controlled trial
- inferior vena cava
- lymph node
- metabolic syndrome
- bone marrow
- pulmonary embolism
- computed tomography
- high throughput
- physical activity
- blood flow
- stem cells
- depressive symptoms
- climate change
- breast reconstruction
- deep brain stimulation
- radical prostatectomy
- data analysis