The efficacy of robot-assisted versus conventional laparoscopic vascular anastomoses in an experimental model.
BACKGROUND
Robot-assisted surgery is thought to facilitate complex laparoscopic movements, enhancing advanced laparoscopic procedures.


OBJECTIVE
To evaluate the benefit of robotic assistance for laparoscopic vascular surgery.


METHODS
Experimental study using prosthetic conduits in a laparoscopic training box.


METHODS
Two surgeons each performed 40 laparoscopic vascular anastomoses alternating with and without robotic assistance. A Zeus-Aesop surgical Robotic system trade mark with 3-D visualisation was used. Each surgeon made 40 anastomoses in total, using different prostheses (5 mm PTFE and 16 mm Dacron) and suture material (Prolene and PTFE). A time-action analysis was performed to evaluate surgical performance. Primary efficacy parameters were quality and leakage of the anastomosis, total time and total number of actions.


RESULTS
Equal quality scores and anastomotic leakage were achieved with both techniques. Robotic assistance resulted in significant longer suture and knot tying time and significant more actions were needed compared to the manual laparoscopic procedures. Significant more failures occurred during the robot-assisted procedures.


CONCLUSIONS
In this study, robotic (Zeus-Aesop) assistance did not improve the laparoscopic performance of the surgeon whilst making vascular anastomoses.
Nio
D
D
Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Balm
R
R
Maartense
S
S
Guijt
M
M
Bemelman
W A
WA
D000714:Anastomosis, Surgical; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012371:Robotics