title: The efficacy of robot-assisted versus conventional laparoscopic vascular anastomoses in an experimental model.
abstract: 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.
authors.affiliation: Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: D
authors.initials: D
authors.lastname: Nio
authors.forename: R
authors.initials: R
authors.lastname: Balm
authors.forename: S
authors.initials: S
authors.lastname: Maartense
authors.forename: M
authors.initials: M
authors.lastname: Guijt
authors.forename: W A
authors.initials: WA
authors.lastname: Bemelman
mesh_terms: D000714:Anastomosis, Surgical; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D012371:Robotics