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

The Maxine & Stuart Frankel Foundation, Computer-Assisted, Robot-Enhanced Surgery (CARES) Program, Children's Hospital of Michigan, Department of Surgery, Wayne State University, Detroit, Michigan

Pediatric Endosurgery & Innovative Technique 2003;7(3):227-232.

Abstract

Background: Computer-assisted robot-enhanced surgery (CARES) can enhance minimally invasive surgery (MIS) by providing a wrist at the end of the instruments and through motion scaling and tremor filtration. Motion scaling and tremor filtration are most enabling at high magnification.

Goal: To explore the possibility of using a surgical robot designed for MIS surgery for open microsurgical procedures.

Materials & Methods: Using a Zeus Microwrist System in conjunction with the triple-alpha port, we performed suture tasks on a glove box with microsurgical suture (8-0 to 10-0) in three different configurations. First, we used a standard 10 mm laparoscope, camera, and the Zeus monitor. Then, we used an operating microscope for visualization with the surgeon at the operative table while controlling the instruments. Third, we allowed the surgeon to sit at the standard Zeus console and transmitted the image from the microscope to the monitor at the Zeus console.

Results: In all three configurations, we were able to manipulate small suture effectively. Using the standard laparoscope, we measured a maximum working magnification of 27 times. At the maximum magnification, we had some difficulty resolving 10-0 suture. Using the operative microscope, we found that the surgeon was crowded with equipment. However, the maximum working magnification was 50 times, the resolution of the fine suture was excellent, and the surgeon had better depth perception. Connecting the operating microscope to the video monitor combined the best features of both systems.



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