title: Robot-assisted vitreoretinal surgery: development of a prototype and feasibility studies in an animal model.
abstract: OBJECTIVE
  To develop a prototype robotic system designed to assist vitreoretinal surgery and to evaluate its accuracy and maneuverability.
  
  
  METHODS
  Experimental study.
  
  
  METHODS
  This study used harvested porcine eyes.
  
  
  METHODS
  After development of a prototype robotic system, pointing accuracy tests of the system were performed on graph paper and in harvested porcine eyes. The average maximal deviation from the aiming point to the actual position of the tip of the instrument was compared between manually conducted procedures and those conducted with robotic assistance. The feasibility of creating posterior vitreous detachment (PVD), retinal vessel sheathotomy (RVS), and retinal vessel microcannulation also were evaluated in porcine eye models, and the success rates of 4 consecutive attempts for each kind of procedure were evaluated.
  
  
  METHODS
  The average maximum deviation in pointing accuracy tests both on graph paper and in animal eye models was a main outcome measure. The success rate of making PVD, RVS, and retinal vessel microcannulation was the other primary outcome measure.
  
  
  RESULTS
  The pointing accuracy was superior with robotic assistance both on graph paper (327.0 microm vs. 32.3 microm) and in animal eye models (140.8 microm vs. 33.5 microm). Creating PVD, RVS, and retinal vessel microcannulation was feasible in 4 of 4 attempts, 4 of 4 attempts, and 2 of 4 attempts, respectively. The 2 failures in microcannulation were considered to be the result of difficulty in visual differentiation between the retinal vessel and retina in harvested porcine eyes.
  
  
  CONCLUSIONS
  Improved accuracy and desirable feasibility of a prototype robotic system to assist vitreoretinal surgery were shown in this study. Research for wider implementation of robot-assisted surgery should be continued; there are some hurdles to overcome.
authors: Department of Ophthalmology, School of Medicine, The University of Tokyo, Tokyo, Japan.
authors: Takashi
authors: T
authors: Ueta
authors: Yoshiharu
authors: Y
authors: Yamaguchi
authors: Yoshihiro
authors: Y
authors: Shirakawa
authors: Taiga
authors: T
authors: Nakano
authors: Ryuichi
authors: R
authors: Ideta
authors: Yasuo
authors: Y
authors: Noda
authors: Akio
authors: A
authors: Morita
authors: Ryo
authors: R
authors: Mochizuki
authors: Naohiko
authors: N
authors: Sugita
authors: Mamoru
authors: M
authors: Mitsuishi
authors: Yasuhiro
authors: Y
authors: Tamaki
mesh_terms: D000818:Animals; D002404:Catheterization / Q000379:methods; D005240:Feasibility Studies; D023421:Models, Animal; D015203:Reproducibility of Results; D012164:Retinal Diseases / Q000601:surgery*; D012171:Retinal Vessels / Q000601:surgery*; D012371:Robotics / Q000295:instrumentation*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D013552:Swine; D014821:Vitrectomy; D020255:Vitreous Detachment / Q000601:surgery*