title: Robotic-assisted laparoscopic microsurgical tubal anastomosis: a human pilot study.
abstract: OBJECTIVE
  To evaluate the feasibility and safety of a robotic device to perform a laparoscopic tubal anastomosis.
  
  
  METHODS
  Prospective pilot study.
  
  
  METHODS
  Tertiary care medical center.
  
  
  METHODS
  Ten patients with previous tubal ligations underwent laparoscopic tubal ligation reversal using a robotic suturing device.
  
  
  METHODS
  Tubal surgery was performed with a robotic system. A two-layered closure was used for all tubes. Four stitches of 8-0 polygalactin sutures were used for each layer.
  
  
  METHODS
  Tubal patency; secondary measures were pregnancy rates, complications, and operative time.
  
  
  RESULTS
  The procedure was completed successfully in all 10 patients. No patient required conversion to an open procedure. The mean time (+/-SD) required to complete the anastomosis of both tubes was 159 +/- 33.8 minutes. Chromotubation at the end of the procedure showed patency in all tubes anastomosed. A postoperative hysterosalpingogram 6 weeks after surgery demonstrated patency in 17 of the 19 (89%) tubes anastomosed. There have been five pregnancies so far. There were no complications.
  
  
  CONCLUSIONS
  Robotic technology can be used safely to create laparoscopic microsurgical anastomoses with adequate patency rates. Robotic technology has the potential to make laparoscopic microsuturing easier.
authors.affiliation: Minimally Invasive Surgery Center, Department of Gynecology and Obstetrics, Cleveland Clinic Foundation, Cleveland, Ohio, USA. falcont@ccf.org
authors.forename: T
authors.initials: T
authors.lastname: Falcone
authors.forename: J M
authors.initials: JM
authors.lastname: Goldberg
authors.forename: H
authors.initials: H
authors.lastname: Margossian
authors.forename: L
authors.initials: L
authors.lastname: Stevens
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D005187:Fallopian Tubes / Q000601:surgery*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D010865:Pilot Projects; D011247:Pregnancy; D018873:Pregnancy Rate; D011446:Prospective Studies; D012371:Robotics