The robotic ENT microsurgery system: A novel robotic platform for microvascular surgery

Area of Science:

• Microsurgery
• Robotics
• Surgical Technology

Background:

• Microvascular surgery demands high precision and tremor-free instrument control.
• Novice surgeons face challenges in achieving the necessary dexterity for microvascular procedures.

Purpose of the Study:

• To assess the feasibility of a novel robotic platform, the Robotic ENT (Ear, Nose, and Throat) Microsurgery System (REMS), for microvascular surgery.
• To evaluate the REMS's ability to reduce tremor and improve instrument handling for both novice and expert users.

Main Methods:

• A prospective feasibility study was conducted in a robotics laboratory.
• Six microvascular-naïve medical students and one expert performed simulated microvascular anastomosis with and without the REMS.
• Trials were blindly graded using a microvascular tremor scale (MTS), and time to completion (TTC) was recorded.

Main Results:

• REMS-assisted trials showed significantly lower MTS scores for novice participants compared to freehand (0.72 vs. 2.40, P < 0.001).
• No significant difference in MTS scores or TTC was observed for the expert surgeon between REMS-assisted and freehand trials.
• Participants reported improved accuracy, instrument handling, and stability with the REMS.

Conclusions:

• The Robotic ENT Microsurgery System (REMS) is a feasible adjunct for microvascular surgery.
• The REMS shows potential as a teaching tool to reduce tremor in novice surgeons.
• The microvascular tremor scale (MTS) is a feasible system for grading microvascular tremor.