Colin G. Knight, M.D.*; Attila Lorincz, M.D.; Alex Cao, M.S.; Kelly Gidell, R.N., B.S.N.; Michael D. Klein, M.D.; Scott E. Langenburg, M.D

The Maxine and Stuart Frankel Foundation Computer-Assisted Robot-Enhanced Surgery Program at Children's Hospital of Michigan Detroit, Michigan, U.S.A.

Abstract

Background: Computer-assisted, robot-enhanced surgery improves laparoscopic and thoracoscopic surgery through tremor-filtration, motion scaling, articulation, and improved ergonomics. Surgeons perform many open cases under magnification which magnifies the tremor present in all surgeons' hands so the tremor filtration and motion scaling of robotic surgery may improve microsurgery. Our goal was to compare microvascular anastomoses performed with a robot-enhanced technique with a standard technique.

Methods: We performed end-to-end anastomoses in 1 mm rat femoral arteries with interrupted 10-0 suture. We compared the anastomotic time, patency, and leak rates between traditional microsurgery techniques (by hand) and a robot-enhanced technique using the Zeus Robotic Surgery system. The surgeon used an operative microscope for visualization in both techniques.

Results: We performed 30 anastomoses by hand and 31 with Zeus. We observed a remarkable degree of tremor filtration in the robot-enhanced cases. Anastomotic times for both techniques demonstrated a learning curve. Anastomoses done by hand (mean 17.2 minutes) were significantly faster than those done with Zeus (mean 27.6 minutes) (p=0.0006). All anastomoses, from both groups, were patent and none leaked after three minutes.

Conclusion: The Zeus system is effective at performing complex, open, microsurgery tasks in vivo, although we were unable to measure an improvement from the remarkable tremor filtration and motion scaling offered by robot-enhanced surgery.



> Back