Microvascular anastomoses performed in rats using a microsurgical telemanipulator.
OBJECTIVE
To determine the feasibility of performing microsurgical procedures with a remote telemanipulator using a rat femoral artery anastomosis model.


METHODS
A remote telemanipulator system was developed that enabled precision movements to be performed at up to 30x magnification. Ten 1-mm femoral artery anastomoses were performed in rats using the telemanipulator, and results were compared to those from a control group in which the procedure was performed with conventional microsurgical techniques. Study endpoints included anastomosis completion time, short-term patency, and procedural complications. Statistical analysis was performed using Student's t-test.


RESULTS
All anastomoses performed by remote telemanipulation and by conventional microsurgery were completed successfully. Anastomosis completion times were 100.0 +/- 18.6 minutes in the telemanipulator group and 38.8 +/- 5.0 minutes using conventional techniques (p < 0.001). Patency in both groups at 5 minutes and at one hour was 100%. No intraoperative complications were encountered. Postmortem ex vivo examination of the excised arterial segment revealed no technical defects in either group.


CONCLUSIONS
Complex procedures requiring a high degree of precision and dexterity can be performed using an electromechanical interface specifically designed for micromanipulation. Performance limitations are similar to those previously reported for remote surgical teleoperation, and most likely reflect incompletely characterized restrictions on multi-sensory information.
Li
R A
RA
Department of Surgery, University of California San Francisco, San Francisco, California 94143-1674, USA.
Jensen
J
J
Bowersox
J C
JC
D000714:Anastomosis, Surgical / Q000295:instrumentation* / Q000379:methods; D000818:Animals; D005240:Feasibility Studies; D005263:Femoral Artery / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000295:instrumentation* / Q000379:methods; D051381:Rats; D017207:Rats, Sprague-Dawley; D012371:Robotics / Q000295:instrumentation*; D014654:Vascular Patency; D014656:Vascular Surgical Procedures / Q000295:instrumentation* / Q000379:methods