Exploration of robotic-assisted surgical techniques in vascular surgery

Robotic-assisted surgical approaches for vascular surgery are feasible regarding minimally invasive exposure, dissection, ligation and skeletonization for varicose vein ligation, anterior spine exposure, femoral-popliteal bypass, femoral vein harvest and aortic aneurysm repair. The authors performed a cadaveric exploration to demonstrate proof of concept and feasibility for a robotic-assisted approached. Surgeon autonomy over endoscopic vision, robotic instrumentation and retraction were noted as key benefits over existing open vascular approaches. Robotic-assisted approaches for vascular surgery enable innovative minimally invasive approaches to disease states not amenable to endovascular repair. Potential reductions in paresthesia through nerve identification were noted during a cadaveric exploration for varicose vein ligation in the setting of chronic venous insufficiency. Minimally invasive femoral artery exposure via a retroperitoneal approach could potentially reduce the morbidity associated with the traditional groin incision. Further exploration and procedure refinement are warranted.