A Comparison of Robotically Assisted Microsurgery versus Manual Microsurgery in Challenging Situations

Area of Science:

• Surgical Technology
• Minimally Invasive Surgery
• Medical Robotics

Background:

• Microsurgery presents challenges due to vessel orientation, accessibility, and wound depth.
• Robotically assisted microsurgery enhances visualization and reduces tremors, potentially improving anastomosis quality over traditional methods.

Purpose of the Study:

• To compare robotically assisted microsurgery with traditional microsurgery in technically demanding situations.
• To evaluate anastomosis time, quality, and Objective Structured Assessment of Technical Skills (OSATS) scores.

Main Methods:

• 160 anastomoses performed on artificial microvessels by novice surgeons after standardized training.
• Comparison of 80 manual versus 80 robotically assisted microsurgery procedures across varying depths (0-20 cm) and sidewall angles (20-30 degrees).
• Evaluation using modified OSATS, anastomosis duration, and a subjective comfort scale.

Main Results:

• In difficult exposures, OSATS scores were comparable; robotically assisted microsurgery showed shorter duration and higher comfort (p < 0.001).
• In easy exposures, traditional microsurgery yielded higher OSATS scores (p = 0.018), while robotically assisted microsurgery had a longer duration (p = 0.008).

Conclusions:

• Traditional microsurgery is superior for technically easy exposures.
• Robotically assisted microsurgery demonstrates benefits in difficult exposures, including reduced surgery time and increased surgeon comfort, with comparable technical skill assessment.