title: Robotically assisted laparoscopic microsurgical tubal reanastomosis: a feasibility study.
abstract: OBJECTIVE
  To assess the feasibility and reproducibility of laparoscopic microsurgical tubal anastomosis using a remote-controlled robot.
  
  
  METHODS
  Descriptive case study.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Eight patients with previous laparoscopic tubal sterilization who requested tubal reanastomosis.
  
  
  METHODS
  Systematization of the operative steps for laparoscopic tubal reanastomosis using a remote-controlled robot.
  
  
  METHODS
  Primary outcome measures were feasibility and reproducibility; secondary measures were tubal patency, operative time, complications, and ergonomic qualities.
  
  
  RESULTS
  The 16 tubes were successfully reanastomosed and patency was confirmed. The mean time that the robotic system was in use was 140 minutes, and mean surgical time was 52 minutes per tube.
  
  
  CONCLUSIONS
  Laparoscopic microsurgical tubal reanastomosis after tubal sterilization can be performed using a remote-controlled robotic system. The robot, which has three-dimensional vision, allows the surgeon to perform ultraprecise manipulations with intraabdominal articulated instruments while providing the necessary degrees of freedom. Systematization of the operative steps allowed performance of the operation at a speed that compares favorably with the time needed for open microsurgical techniques. Larger series are needed to assess postoperative pregnancy rates.
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital Saint-Pierre, Free University Brussels, Brussels, Belgium. michel_degueldre@stpierre-bru.be
authors.forename: M
authors.initials: M
authors.lastname: Degueldre
authors.forename: J
authors.initials: J
authors.lastname: Vandromme
authors.forename: P T
authors.initials: PT
authors.lastname: Huong
authors.forename: G B
authors.initials: GB
authors.lastname: Cadière
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D005186:Fallopian Tube Patency Tests; D005187:Fallopian Tubes / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008866:Microsurgery / Q000379:methods*; D015203:Reproducibility of Results; D012371:Robotics; D013243:Sterilization Reversal / Q000379:methods*