RoboticScope-Assisted Microanastomosis in a Chicken Leg Model

Area of Science:

• Neurosurgery
• Surgical Technology
• Medical Robotics

Background:

• Exoscopes are emerging as safe and effective alternatives to traditional operating microscopes (OM) in neurosurgery.
• Robotic systems like the RoboticScope (RS) exoscope integrate robotics and automation, offering digital 3D imaging and head-mounted displays for enhanced surgical visualization and control.
• The RS features a six-axis robotic arm with two cameras for stereovision, allowing surgeons precise control over the viewpoint via head movements.

Purpose of the Study:

• To demonstrate the feasibility of using the RoboticScope (RS) exoscope for vessel microanastomosis training.
• To evaluate the effectiveness of the RS in a simulated surgical training environment using an animal model.
• To assess trainee satisfaction with the RS's features, including visualization, ergonomics, and control.

Main Methods:

• Vessel microanastomosis training was conducted on chicken legs using the RS over a one-month trial period.
• Procedures were performed by a trainee neurosurgeon under supervision, focusing on interrupted suturing techniques with 10.0 nylon thread.
• Evaluated metrics included occlusion time, bypass patency, and trainee satisfaction with device features like light intensity, autofocus, mobility, and helmet ergonomics.

Main Results:

• Ten RS-assisted microanastomoses were successfully performed, including end-to-side, end-to-end, and side-to-side configurations on vessels as small as 1mm.
• Occlusion time significantly improved from 50 to 24 minutes during the training period, with all anastomoses demonstrating contrast patency.
• Trainee satisfaction was high, with 7 out of 10 cases reporting complete satisfaction, although adaptation to the digital image was noted as a learning curve.

Conclusions:

• The RoboticScope (RS) presents a viable new method for microanastomosis training, serving as an alternative or supplement to standard operating microscopes.
• Key advantages include hands-free microsuturing, automatic zooming with instant depth perception, and precise focus control via head movements.
• Further refinement of the RS, particularly its helmet design, could position it as a cutting-edge tool for future vessel microanastomosis procedures, with this study being an early report on its use in animal models.