Robotics in microsurgery: Use of a surgical robot to perform a free flap in a pig

Authors

  • Ryan D. Katz M.D.,

    1. Division of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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  • Gedge D. Rosson M.D.,

    1. Division of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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  • Jesse A. Taylor M.D.,

    1. Division of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
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  • Navin K. Singh M.D.

    Corresponding author
    1. Division of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
    • Division of Plastic, Reconstructive, and Maxillofacial Surgery, Johns Hopkins University School of Medicine, McElderry 8152-C, 601 North Caroline St., Baltimore, MD 21287-0980
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  • None of the authors have any proprietary interest in the da Vinci® robot. None of the authors have received funding from Intuitive Surgical. The Johns Hopkins University School of Medicine has not received funding from Intuitive Surgical.

Abstract

We present the concept that a surgical robot may be used to successfully perform a free flap. To study different microsurgical techniques, a porcine free flap model was developed in our laboratory. Dissection of the free flap model and isolation of the vessels were completed under traditional loupe magnification. The da Vinci® robot was then used to perform vessel adventitiectomy and microanastomoses. The model was observed for 4 h postoperatively, noting flap color, temperature, capillary refill, and Doppler signal. At the end of this period, the flap was noted to be viable; anastomoses were evaluated and found to be grossly and microscopically patent. Advantages conferred by the da Vinci® robot include elimination of tremor, scalable movements, fully articulating instruments with six degrees of spatial freedom, and a dynamic three-dimensional visualization system. Drawbacks include the cost and the absence of true microsurgical instruments. © 2005 Wiley-Liss, Inc. Microsurgery 25:566–569, 2005.

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