Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial
Abstract Technical advances in microsurgery have enabled complex oncological reconstructions by performing free tissue transfers, nerve and lymphatic reconstructions. However, the manual abilities required to perform microsurgery can be affected by human fatigue and physiological tremor resulting in...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-08-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-41143-z |
| _version_ | 1797199430361808896 |
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| author | Gerardo Malzone Giulio Menichini Marco Innocenti Alberto Ballestín |
| author_facet | Gerardo Malzone Giulio Menichini Marco Innocenti Alberto Ballestín |
| author_sort | Gerardo Malzone |
| collection | DOAJ |
| description | Abstract Technical advances in microsurgery have enabled complex oncological reconstructions by performing free tissue transfers, nerve and lymphatic reconstructions. However, the manual abilities required to perform microsurgery can be affected by human fatigue and physiological tremor resulting in tissue damage and compromised outcomes. Robotic assistance has the potential to overcome issues of manual microsurgery by improving clinical value and anastomoses’ outcomes. The Symani Surgical System, a robotic platform designed for microsurgery, was used in this in-vivo preclinical study using a rat animal model. The tests included anastomoses on veins and arteries performed by microsurgeons manually and robotically, with the latter approach using Symani. The anastomoses were assessed for patency, histopathology, and execution time. Patency results confirmed that the robotic and manual techniques for venous and arterial anastomoses were equivalent after anastomosis, however, the time to perform the anastomosis was longer with the use of the robot (p < 0.0001). Histological analysis showed less total average host reaction score at the anastomotic site in robotic anastomosis for both veins and arteries. This study demonstrates the equivalence of vessel patency after microsurgical anastomoses with the robotic system and with manual technique. Furthermore, robotic anastomosis has proven to be slightly superior to manual anastomosis in terms of decreased tissue damage, as shown by histological analysis. |
| first_indexed | 2024-03-10T17:50:18Z |
| format | Article |
| id | doaj.art-d6b79ceea7d04f4d866cd5448308f083 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-24T07:15:38Z |
| publishDate | 2023-08-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-d6b79ceea7d04f4d866cd5448308f0832024-04-21T11:19:59ZengNature PortfolioScientific Reports2045-23222023-08-011311810.1038/s41598-023-41143-zMicrosurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trialGerardo Malzone0Giulio Menichini1Marco Innocenti2Alberto Ballestín3Division of Plastic, Reconstructive and Microsurgery, CTO Careggi University HospitalDivision of Plastic, Reconstructive and Microsurgery, CTO Careggi University HospitalDivision of Plastic, Reconstructive and Microsurgery, CTO Careggi University HospitalTumor Microenvironment Laboratory, Institut CurieAbstract Technical advances in microsurgery have enabled complex oncological reconstructions by performing free tissue transfers, nerve and lymphatic reconstructions. However, the manual abilities required to perform microsurgery can be affected by human fatigue and physiological tremor resulting in tissue damage and compromised outcomes. Robotic assistance has the potential to overcome issues of manual microsurgery by improving clinical value and anastomoses’ outcomes. The Symani Surgical System, a robotic platform designed for microsurgery, was used in this in-vivo preclinical study using a rat animal model. The tests included anastomoses on veins and arteries performed by microsurgeons manually and robotically, with the latter approach using Symani. The anastomoses were assessed for patency, histopathology, and execution time. Patency results confirmed that the robotic and manual techniques for venous and arterial anastomoses were equivalent after anastomosis, however, the time to perform the anastomosis was longer with the use of the robot (p < 0.0001). Histological analysis showed less total average host reaction score at the anastomotic site in robotic anastomosis for both veins and arteries. This study demonstrates the equivalence of vessel patency after microsurgical anastomoses with the robotic system and with manual technique. Furthermore, robotic anastomosis has proven to be slightly superior to manual anastomosis in terms of decreased tissue damage, as shown by histological analysis.https://doi.org/10.1038/s41598-023-41143-z |
| spellingShingle | Gerardo Malzone Giulio Menichini Marco Innocenti Alberto Ballestín Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial Scientific Reports |
| title | Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial |
| title_full | Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial |
| title_fullStr | Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial |
| title_full_unstemmed | Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial |
| title_short | Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial |
| title_sort | microsurgical robotic system enables the performance of microvascular anastomoses a randomized in vivo preclinical trial |
| url | https://doi.org/10.1038/s41598-023-41143-z |
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