TY - JOUR
T1 - Robotic-assisted microvascular surgery
T2 - skill acquisition in a rat model
AU - Clarke, Nicholas S.
AU - Price, Johnathan
AU - Boyd, Travis
AU - Salizzoni, Stefano
AU - Zehr, Kenton J.
AU - Nieponice, Alejandro
AU - Bajona, Pietro
N1 - Publisher Copyright:
© 2017, Springer-Verlag London Ltd.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Microsurgery is a technically demanding field with long learning curves. Robotic-assisted microsurgery has the ability to decrease these learning curves. We, therefore, sought to assess the feasibility of robotic-assisted microvascular surgery in a rat model, and whether this could be translated into a worthwhile skills acquisition exercise for residents. Twenty-eight rats underwent microvascular anastomosis. Procedures were performed by a trained microvascular surgeon with no robotic experience (n = 14), or a trained robotic surgeon with no microvascular experience (n = 14). Anesthetized rats were subjected to complete transection and end-to-end anastomosis of the abdominal aorta using 10–0 prolene. Manually (n = 6) and robotic-assisted (n = 8) procedures were performed by both surgeons. A successful procedure required a patent anastomosis and no bleeding. After approximately 35 days, angiography and histopathological studies of the anastomoses were performed. Median times for robotic-assisted anastomoses were 37.5 (34.2–42.7) min for the microsurgeon and 38.5 (32.7–52) min for robotic surgeon. In the manual group, it took 17 (13.5–23) min for microsurgeon and 44 (34.5–60) min for robotic surgeon. Within the robotic-assisted group, there was a trend toward improvement in both surgeons, but greater in the microsurgeon. Robotic-assisted microvascular anastomosis in a rat model is a feasible skill acquisition exercise. By eliminating the need for a skilled microsurgical assistant, as well as, improved microsurgical technology, the robotic system may prove to be a crucial player in future microsurgical skill training.
AB - Microsurgery is a technically demanding field with long learning curves. Robotic-assisted microsurgery has the ability to decrease these learning curves. We, therefore, sought to assess the feasibility of robotic-assisted microvascular surgery in a rat model, and whether this could be translated into a worthwhile skills acquisition exercise for residents. Twenty-eight rats underwent microvascular anastomosis. Procedures were performed by a trained microvascular surgeon with no robotic experience (n = 14), or a trained robotic surgeon with no microvascular experience (n = 14). Anesthetized rats were subjected to complete transection and end-to-end anastomosis of the abdominal aorta using 10–0 prolene. Manually (n = 6) and robotic-assisted (n = 8) procedures were performed by both surgeons. A successful procedure required a patent anastomosis and no bleeding. After approximately 35 days, angiography and histopathological studies of the anastomoses were performed. Median times for robotic-assisted anastomoses were 37.5 (34.2–42.7) min for the microsurgeon and 38.5 (32.7–52) min for robotic surgeon. In the manual group, it took 17 (13.5–23) min for microsurgeon and 44 (34.5–60) min for robotic surgeon. Within the robotic-assisted group, there was a trend toward improvement in both surgeons, but greater in the microsurgeon. Robotic-assisted microvascular anastomosis in a rat model is a feasible skill acquisition exercise. By eliminating the need for a skilled microsurgical assistant, as well as, improved microsurgical technology, the robotic system may prove to be a crucial player in future microsurgical skill training.
KW - Microvascular surgery
KW - Robotic microvascular simulation
KW - Robotic-assisted surgery
KW - Surgical education
UR - http://www.scopus.com/inward/record.url?scp=85028570051&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85028570051&partnerID=8YFLogxK
U2 - 10.1007/s11701-017-0738-5
DO - 10.1007/s11701-017-0738-5
M3 - Article
C2 - 28812257
AN - SCOPUS:85028570051
SN - 1863-2483
VL - 12
SP - 331
EP - 336
JO - Journal of Robotic Surgery
JF - Journal of Robotic Surgery
IS - 2
ER -