Abstract
Background
This research aims to validate the proficiency and accuracy of the robotic microsurgery
platform using rat femoral vessel model.
Methods
A total of 256 rat femoral vessels were performed, half using robotic and the other
by manual microanastomosis by eight microsurgeons with less than 5 years of experience
given eight trials (rats) each. Vessel demographics, proficiency (duration of suture
and Structured Assessment of Robotic Microsurgical Skills [SARMS]), and accuracy (patency
and scanning electron microscopic [SEM]) were analyzed between the two groups.
Results
Using the robot, an average of four trials was needed to reach a plateau in total
anastomosis time and patency. Significant more time was required for each vessel anastomosis
(34.33 vs. 21.63 minutes on the eighth trial, p < 0.001) one factor being a higher number of sutures compared with the handsewn group
(artery: 7.86 ± 0.51 vs. 5.86 ± 0.67, p = 0.035, vein: 12.63 ± 0.49 vs. 9.57 ± 0.99, p = 0.055). The SARMS scores became nonsignificant between the two groups on the fourth
trial. The SEM showed a higher tendency of unevenly spaced sutures, infolding, and
tears in the vessel wall for the handsewn group.
Conclusion
Using the robot, similar patency, accuracy, and proficiency can be reached through
a fast but steep learning process within four trials (anastomosis of eight vessels)
as the handsewn group. The robotic anastomosis may take longer time, but this is due
to the increased number of sutures reflecting higher precision and accuracy. Further
insight of precision and accuracy was found through the SEM demonstrating the possibility
of the robot to prevent unexpected and unwanted complications.
Keywords
robotic microsurgery - supermicrosurgery - robotic-assisted surgery
