title: Robotic microsurgery optimization.
abstract: The increased application of the da Vinci robotic platform (Intuitive Surgical Inc.) for microsurgery has led to the development of new adjunctive surgical instrumentation. In microsurgery, the robotic platform can provide high definition 12×-15× digital magnification, broader range of motion, fine instrument handling with decreased tremor, reduced surgeon fatigue, and improved surgical productivity. This paper presents novel adjunctive tools that provide enhanced optical magnification, micro-Doppler sensing of vessels down to a 1-mm size, vein mapping capabilities, hydro-dissection, micro-ablation technology (with minimal thermal spread-CO2 laser technology), and confocal microscopy to provide imaging at a cellular level. Microsurgical outcomes from the use of these tools in the management of patients with infertility and chronic groin and testicular pain are reviewed. All these instruments have been adapted for the robotic console and enhance the robot-assisted microsurgery experience. As the popularity of robot-assisted microsurgery grows, so will its breadth of instrumentation.
authors.affiliation: Personalized Urology & Robotics, The PUR Clinic, South Lake Hospital, Clermont, FL, USA.
authors.forename: Jamin V
authors.initials: JV
authors.lastname: Brahmbhatt
authors.affiliation: Personalized Urology & Robotics, The PUR Clinic, Memorial Ankara Hospital, Ankara, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Gudeloglu
authors.affiliation: Department of Hand Surgery, Strasbourg University Hospitals, Strasbourg, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Liverneaux
authors.affiliation: Personalized Urology & Robotics, The PUR Clinic, South Lake Hospital, Clermont, FL, USA.
authors.forename: Sijo J
authors.initials: SJ
authors.lastname: Parekattil
keywords: Equipment and supplies; Instrumentation; Microsurgery; Robotics