Nerve repair in telemicrosurgery: an experimental study.

Area of Science:

• Neurosurgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Microsurgery has advanced peripheral nerve lesion treatment since the 1960s.
• Physiological tremor limits microsurgery precision.
• Telesurgery emerged in the 1990s for remote surgical procedures.

Purpose of the Study:

• To assess the feasibility of peripheral nerve repair using telemicrosurgery.
• To evaluate the impact of robotic assistance on nerve repair outcomes.

Main Methods:

• Peripheral nerve repair was performed using the Da Vinci S robot on anatomical specimens from rat, pig, and human.
• Four anatomical epiperineural repairs and one neurotrophic repair with a nerve regrowth guide were conducted.
• The telesurgical system was utilized for the repair procedures.

Main Results:

• Telemicrosurgery successfully eliminated physiological tremor during nerve repair.
• Repairs were performed without damaging twisting movements of nerve ends.
• The robotic system enhanced the overview of the surgical field, enabling precise repairs.

Conclusions:

• Telesurgery is a feasible and safe technique for peripheral nerve repair.
• Robotic assistance in telemicrosurgery counteracts physiological tremor, improving surgical precision.
• Telemicrosurgery offers enhanced visualization and control for both anatomical and neurotrophic nerve repair techniques.