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 that 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 (Computer Motion, Goleta, California). 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 time, 17.2 minutes) were significantly
faster than those done with Zeus (mean time, 27.6 minutes) (P = 0.0006). All anastomoses
from both groups were patent, and none leaked after 3 minutes.
Conclusion: The Zeus system is effective at performing complex, open, microsurgery tasks in vivo.
There was no measurable benefit from the remarkable tremor filtration and motion scaling offered
by robot-enhanced surgery.
