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CC BY-NC-ND 4.0 · J Reconstr Microsurg Open 2024; 09(01): e27-e33
DOI: 10.1055/a-2239-5212
Original Article

Conventional and Robot-Assisted Microvascular Anastomosis: Systematic Review

Benedictus A. Susanto
1   Medical Education Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
,
Nadine Aurelie
1   Medical Education Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
,
William Nathaniel
1   Medical Education Program, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
,
Parintosa Atmodiwirjo
2   Division of Plastic Surgery, Department of Surgery, Reconstructive Microsurgery and Oncoplasty Section, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
,
Mohamad R. Ramadan
2   Division of Plastic Surgery, Department of Surgery, Reconstructive Microsurgery and Oncoplasty Section, Dr. Cipto Mangunkusumo National Central Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
,
Risal Djohan
3   Department of Plastic Surgery, Cleveland Clinic, Cleveland, Ohio
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Abstract

Background The complexity of plastic microsurgery yields many risks. Robot assistance has been sought to maximize outcome and minimize complications. Reportedly, it offers increased dexterity and flexibility with attenuated human flaws, such as tremors and fatigue. This systematic review will further investigate that claim.

Methods A systematic search was conducted for operative outcomes and operator experience of reconstructive plastic microsurgery compared between conventional and robot-assisted procedures. Data were summarized then meta-analyzed or qualitatively assessed and critically appraised to determine the difference robot assistance offers.

Results This review comprises four studies, mainly investigating robot-assisted microvascular anastomosis. Meta-analysis of anastomosis time reveals that robot assistance takes more time than conventional without offering substantial health-related improvements. However, it offers greater comfort, consistency, and flexibility for operators.

Conclusion Robot assistance lengthens operative times because of its relative lack of implementation and subsequent lack of experienced operators. Times were quick to be improved as repeated procedures were performed and technical complications can be resolved by more experience with robotic equipment. Furthermore, it generally offers better operator experience. Despite this, robot assistance does not offer a better health outcome compared with conventional anastomosis, although its benefits may lie in aesthetic outcomes instead. Exploration of that aspect as well as nonsummarizable health outcomes are the two primary limitations of this review that warrants further investigation into the subject.

Keywords

microvascular anastomosis - robot assistance - plastic surgery


Publication History

Received: 27 July 2023

Accepted: 18 December 2023

Accepted Manuscript online:
05 January 2024

Article published online:
27 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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