title: Computer-assisted, robot-enhanced open microsurgery in an animal model.
abstract: BACKGROUND
  Computer-assisted, robot-enhanced surgery improves laparoscopic and thoracoscopic surgery through tremor filtration, motion scaling, articulation, and improved ergonomics. Surgeons perform many open cases under magnification that magnifies the tremor present in all surgeons' hands, so the tremor filtration and motion scaling of robotic surgery may improve microsurgery. Our goal was to compare microvascular anastomoses performed with a robot-enhanced technique with a standard technique.
  
  
  METHODS
  We performed end-to-end anastomoses in 1-mm rat femoral arteries with interrupted 10-0 suture. We compared the anastomotic time, patency, and leak rates between traditional microsurgery techniques (by hand) and a robot-enhanced technique using the Zeus robotic surgery system (Computer Motion, Goleta, California). The surgeon used an operative microscope for visualization in both techniques.
  
  
  RESULTS
  We performed 30 anastomoses by hand and 31 with Zeus. We observed a remarkable degree of tremor filtration in the robot-enhanced cases. Anastomotic times for both techniques demonstrated a learning curve. Anastomoses done by hand (mean time, 17.2 minutes) were significantly faster than those done with Zeus (mean time, 27.6 minutes) (P = 0.0006). All anastomoses from both groups were patent, and none leaked after 3 minutes.
  
  
  CONCLUSIONS
  The Zeus system is effective at performing complex, open, microsurgery tasks in vivo. There was no measurable benefit from the remarkable tremor filtration and motion scaling offered by robot-enhanced surgery.
authors.affiliation: The Maxine and Stuart Frankel Foundation Computer-Assisted Robot-Enhanced Surgery Program at Children's Hospital of Michigan, Detroit, Michigan 48201, USA. knight_colin@yahoo.com
authors.forename: Colin G
authors.initials: CG
authors.lastname: Knight
authors.forename: Attila
authors.initials: A
authors.lastname: Lorincz
authors.forename: Alex
authors.initials: A
authors.lastname: Cao
authors.forename: Kelly
authors.initials: K
authors.lastname: Gidell
authors.forename: Michael D
authors.initials: MD
authors.lastname: Klein
authors.forename: Scott E
authors.initials: SE
authors.lastname: Langenburg
mesh_terms: D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D005260:Female; D005263:Femoral Artery / Q000601:surgery; D008866:Microsurgery / Q000379:methods*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012371:Robotics / Q000379:methods*; D014654:Vascular Patency