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Open Access
CC BY 4.0 · J Reconstr Microsurg
DOI: 10.1055/a-2460-4940
Original Article

Further Validating the Robotic Microsurgery Platform through Preclinical Studies on Rat Femoral Artery and Vein

Jeongmok Cho
1   Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea
,
Donggeon Kim
1   Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea
,
Taehyun Kim
1   Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea
,
Changsik John Pak
1   Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea
,
Hyunsuk Peter Suh
1   Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea
,
Joon Pio Hong 
1   Department of Plastic and Reconstructive Surgery, University of Ulsan, College of Medicine, Seoul Asan Medical Center, Seoul, Korea
› Author Affiliations
Funding This research was funded in part by MMI. Symani robotic platform and necessary robotic instrumentation was provided by MMI as part of the research funding agreement between MMI and Asan Medical Center. The senior author J.P.H. is a consultant for MMI.
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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


Publication History

Received: 11 July 2024

Accepted: 16 October 2024

Accepted Manuscript online:
04 November 2024

Article published online:
17 January 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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