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Robotic-assisted laparoscopic microsurgical tubal anastomosis: a human pilot study
T Falcone1, J M Goldberg, H Margossian
1Minimally Invasive Surgery Center, Department of Gynecology and Obstetrics, Cleveland Clinic Foundation, Cleveland, Ohio, USA. falcont@ccf.org
Objective:
To evaluate the feasibility and safety of a robotic device to perform a laparoscopic tubal anastomosis.
Design:
Prospective pilot study.
Setting:
Tertiary care medical center.
Patient(S):
Ten patients with previous tubal ligations underwent laparoscopic tubal ligation reversal using a robotic suturing device.
Intervention(S):
Tubal surgery was performed with a robotic system. A two-layered closure was used for all tubes. Four stitches of 8-0 polygalactin sutures were used for each layer.
Main Outcome Measure(S):
Tubal patency; secondary measures were pregnancy rates, complications, and operative time.
Result(S):
The procedure was completed successfully in all 10 patients. No patient required conversion to an open procedure. The mean time (+/-SD) required to complete the anastomosis of both tubes was 159 +/- 33.8 minutes. Chromotubation at the end of the procedure showed patency in all tubes anastomosed. A postoperative hysterosalpingogram 6 weeks after surgery demonstrated patency in 17 of the 19 (89%) tubes anastomosed. There have been five pregnancies so far. There were no complications.
Conclusion(S):
Robotic technology can be used safely to create laparoscopic microsurgical anastomoses with adequate patency rates. Robotic technology has the potential to make laparoscopic microsuturing easier.
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