title: The Oberlin procedure for restoration of elbow flexion with the da Vinci robot: four cases.
abstract: Robotics allows up to 40× visual magnification and 10× magnification of the surgeon's movements, and eliminates physiologic tremors. These properties should allow the development of mini-invasive limb surgery, especially of the brachial plexus. The purpose of this work was to test the feasibility of the restoration of elbow flexion according to the technique of Oberlin using a da Vinci robot. The authors' series included four patients (average age, 31 years) presenting with elbow flexion paralysis. They were operated on 8 months after injury using a da Vinci S robot. In three patients, the open technique (technique 1) was used, and the mini-invasive approach (technique 2) was used for the last one. Strength of elbow flexion was measured. After 1-year follow-up, all of the patients had recovered elbow flexion. No sensory or motor deficit was found in the ulnar nerve territory. There was no difficulty with technique 1; technique 2, however, required a conversion to technique 1 because of difficulty visualizing the operative field. The results of the authors' series show the feasibility of the robot-assisted technique for the Oberlin procedure. The lack of sensory feedback was not an issue. The development of specific retractors and instruments should improve the mini-invasive technique.
  
  
  METHODS
  Therapeutic, V.
authors.affiliation: Strasbourg, France; Tokyo, Japan; and Charleroi, Belgium From the Department of Hand Surgery, Strasbourg University Hospitals; the Department of Orthopedics, Juntendo University; and the Department of Orthopedics, Grand Hôpital.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Naito
authors.forename: Sybille
authors.initials: S
authors.lastname: Facca
authors.forename: Thierry
authors.initials: T
authors.lastname: Lequint
authors.forename: Phillipe A
authors.initials: PA
authors.lastname: Liverneaux
mesh_terms: D000328:Adult; D020516:Brachial Plexus Neuropathies / Q000601:surgery*; D004551:Elbow Joint / Q000502:physiology / Q000601:surgery*; D005240:Feasibility Studies; D006801:Humans; D008875:Middle Aged; D016067:Nerve Transfer / Q000295:instrumentation / Q000379:methods*; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012371:Robotics; D055815:Young Adult