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Robotic technology in wound healing osteomyelitis
Introduction:
We initiated the use of robotic instrumentation in the surgical management of complex, recurrent non-healing wounds due to osteomyelitis in July 2012. The primary objective is to demonstrate the benefit of the visual superiority and more precise tissue dissection offered by robotic technology.

Material and methods:
After obtaining approval for the use of the da Vinci® robotic surgical system (Intuitive Surgical®) as an “exoscopic” approach at our institution, three patients were enrolled in the protocol wound debridement/osteomyelitis/da Vinci®.
We will be presenting the clinical manifestations and imaging diagnosis of osteomyelitis, as well as outlining the surgical procedure and the use of the robotic system for soft tissue and bone debridement. The complimentary application of bioengineering tissue enhancement material was used in one patient (Cryopreserved amniotic membrane Amniox®), and in two patients (Apligraf Organogenesis, Inc). Comprehensive postoperative wound management will be discussed.

Results:
Two patients had completely healed wounds at 130 and 230 days respectively, without functional joint deficit. Although the third patient had only 3 weeks of follow-up, they appear to be progressing as expected.

Conclusions:
The basic capability of robotic technology (visual and manual control) appears to facilitate the surgical management of osteomyelitis, particularly in restricted anatomical spaces and in proximity to joints. We propose further clinical research and outcome healing measurements with this subgroup of patients that might otherwise require amputation.
B Martinez
Lecture
5 years ago
92 views
3 likes
0 comments
09:44
Robotic technology in wound healing osteomyelitis
Introduction:
We initiated the use of robotic instrumentation in the surgical management of complex, recurrent non-healing wounds due to osteomyelitis in July 2012. The primary objective is to demonstrate the benefit of the visual superiority and more precise tissue dissection offered by robotic technology.

Material and methods:
After obtaining approval for the use of the da Vinci® robotic surgical system (Intuitive Surgical®) as an “exoscopic” approach at our institution, three patients were enrolled in the protocol wound debridement/osteomyelitis/da Vinci®.
We will be presenting the clinical manifestations and imaging diagnosis of osteomyelitis, as well as outlining the surgical procedure and the use of the robotic system for soft tissue and bone debridement. The complimentary application of bioengineering tissue enhancement material was used in one patient (Cryopreserved amniotic membrane Amniox®), and in two patients (Apligraf Organogenesis, Inc). Comprehensive postoperative wound management will be discussed.

Results:
Two patients had completely healed wounds at 130 and 230 days respectively, without functional joint deficit. Although the third patient had only 3 weeks of follow-up, they appear to be progressing as expected.

Conclusions:
The basic capability of robotic technology (visual and manual control) appears to facilitate the surgical management of osteomyelitis, particularly in restricted anatomical spaces and in proximity to joints. We propose further clinical research and outcome healing measurements with this subgroup of patients that might otherwise require amputation.
Neurotisation to the axillary nerve by the nerve to the triceps
Nerve transfer to the deltoid muscle using the nerve of the long head of the triceps is a reliable method for deltoid function restoration. The aim of this retrospective study was to report the results of the nerve transfer procedure to the deltoid muscle using the nerve of the long head of the triceps by means of a robot.
Our series included six patients (mean age: 36.3 years) with total deltoid muscle paralysis. A da Vinci S® robot was placed in position. After dissection of the quadrilateral and triangular spaces, the anterior branch of the axillary nerve and the branch to the long head of the triceps were transected, then robotically sutured with two 10/0 Nylon stitches. In 2 cases, an endoscopic procedure was attempted under carbon dioxide insufflation.
In all patients except one, deltoid function against resistance (M4) was obtained at the last follow-up evaluation. The average shoulder abduction was 112 degrees. No elbow extension weakness was observed. In 2 cases with the endoscopic technique, vision was blurred and conversion to the open technique was performed.
The advantages of robotic microsurgery are motion scaling and disappearance of physiological tremors. Reasons for failure of the endoscopic technique could be explained by insufficient pressure. We had no difficulty using the robot without sensory feedback. The robot-assisted nerve transfer to the deltoid muscle using the nerve of the long head of the triceps was a feasible application for restoration of shoulder abduction after brachial plexus or axillary nerve injury.
H Miyamoto
Lecture
5 years ago
66 views
2 likes
0 comments
07:07
Neurotisation to the axillary nerve by the nerve to the triceps
Nerve transfer to the deltoid muscle using the nerve of the long head of the triceps is a reliable method for deltoid function restoration. The aim of this retrospective study was to report the results of the nerve transfer procedure to the deltoid muscle using the nerve of the long head of the triceps by means of a robot.
Our series included six patients (mean age: 36.3 years) with total deltoid muscle paralysis. A da Vinci S® robot was placed in position. After dissection of the quadrilateral and triangular spaces, the anterior branch of the axillary nerve and the branch to the long head of the triceps were transected, then robotically sutured with two 10/0 Nylon stitches. In 2 cases, an endoscopic procedure was attempted under carbon dioxide insufflation.
In all patients except one, deltoid function against resistance (M4) was obtained at the last follow-up evaluation. The average shoulder abduction was 112 degrees. No elbow extension weakness was observed. In 2 cases with the endoscopic technique, vision was blurred and conversion to the open technique was performed.
The advantages of robotic microsurgery are motion scaling and disappearance of physiological tremors. Reasons for failure of the endoscopic technique could be explained by insufficient pressure. We had no difficulty using the robot without sensory feedback. The robot-assisted nerve transfer to the deltoid muscle using the nerve of the long head of the triceps was a feasible application for restoration of shoulder abduction after brachial plexus or axillary nerve injury.
Oberlin's procedure for restoration of elbow flexion with a da Vinci® robot
Robotics allow visual magnification up to 40 times, and a 10 time-magnification of the surgeon’s movements, as well as the elimination of physiological tremors. These properties should allow for the development of minimally invasive limb surgery, especially brachial plexus surgery. The purpose of this work was to test the feasibility of elbow flexion restoration according to the technique of Oberlin using a da Vinci® robot. Our series included 4 patients (mean 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 minimally invasive approach (technique 2) was used for the last one. Strength of elbow flexion was measured. After 1 year of follow-up, all patients recovered elbow flexion. No sensory nor 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 due to the difficulty in visualizing the operative field. The results of our 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 minimally invasive technique.
K Naito
Lecture
5 years ago
113 views
2 likes
0 comments
07:00
Oberlin's procedure for restoration of elbow flexion with a da Vinci® robot
Robotics allow visual magnification up to 40 times, and a 10 time-magnification of the surgeon’s movements, as well as the elimination of physiological tremors. These properties should allow for the development of minimally invasive limb surgery, especially brachial plexus surgery. The purpose of this work was to test the feasibility of elbow flexion restoration according to the technique of Oberlin using a da Vinci® robot. Our series included 4 patients (mean 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 minimally invasive approach (technique 2) was used for the last one. Strength of elbow flexion was measured. After 1 year of follow-up, all patients recovered elbow flexion. No sensory nor 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 due to the difficulty in visualizing the operative field. The results of our 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 minimally invasive technique.
Small vessels endoscopic anastomosis: feasibility study
The size of incisions for free muscle flaps is often very large, and a source of deep adhesions and unesthetic scars but it is justified by performing the microsurgical step comfortably. In the hope of shortening the size of incisions, the objective of this work was to study the feasibility of vascular micro-anastomoses using an endoscopic approach. The material consisted of 2 cadavers, a tele-manipulator, and a vascular clamp. The antebrachial skin was detached, then distended by gas insufflations. Four incisions, one centimeter each, allowed for the set-up of 4 trocars connected to the tele-manipulator. The artery was dissected (radial or ulnar) and the vascular clamp was introduced under the skin through one of the trocars, and then positioned on the dissected artery. The vascular anastomosis was performed with the use of a 10/0 Nylon suture. The anastomosis lasted 2 hours under insufflation with no leaks. The 2 arteries were identified, then dissected without difficulty. The anastomosis was performed in adequate conditions. The mounting and demounting of the clamp were time-consuming. The main difficulties were caused by a long suture and a very fragile needle. Our results demonstrate the feasibility of vascular micro-anastomosis using an endoscopic approach. The next step is to perform the first clinical case (e.g., on a latissimus dorsi free muscle flap).
E Robert
Lecture
5 years ago
138 views
3 likes
0 comments
08:37
Small vessels endoscopic anastomosis: feasibility study
The size of incisions for free muscle flaps is often very large, and a source of deep adhesions and unesthetic scars but it is justified by performing the microsurgical step comfortably. In the hope of shortening the size of incisions, the objective of this work was to study the feasibility of vascular micro-anastomoses using an endoscopic approach. The material consisted of 2 cadavers, a tele-manipulator, and a vascular clamp. The antebrachial skin was detached, then distended by gas insufflations. Four incisions, one centimeter each, allowed for the set-up of 4 trocars connected to the tele-manipulator. The artery was dissected (radial or ulnar) and the vascular clamp was introduced under the skin through one of the trocars, and then positioned on the dissected artery. The vascular anastomosis was performed with the use of a 10/0 Nylon suture. The anastomosis lasted 2 hours under insufflation with no leaks. The 2 arteries were identified, then dissected without difficulty. The anastomosis was performed in adequate conditions. The mounting and demounting of the clamp were time-consuming. The main difficulties were caused by a long suture and a very fragile needle. Our results demonstrate the feasibility of vascular micro-anastomosis using an endoscopic approach. The next step is to perform the first clinical case (e.g., on a latissimus dorsi free muscle flap).
Robotic surgery training center, a Brazilian experience
Introduction:
As there is no training protocol for robotic microsurgery established by Intuitive Surgical®, we chose to prepare a bibliographic revision about microsurgery training protocols, associating training with inanimate objects and practical training in biological material (animal model).
Methods:
A systematic review was performed crossing the words education and robotics using the PUBMED database. The search presented a result of 249 articles. We considered articles published in English over the past 10 years, having as a selection criteria for inclusion, the description of one of the following items: 1) techniques of teaching; 2) the learning curve or the training of basic principles of surgery as the basis of a training program; 19 published articles were eligible.
Discussion:
The possibility to adapt teaching techniques which are used in robotic laparoscopic videos and connecting theory with practice. The learning process has been organized in different levels of teaching.
Conclusion:
The fact that there are no recognized protocols for robotic microsurgery by Intuitive Surgical®, creates a necessity to develop teaching methodology standards for the robotic microsurgeon in order to be trained in a safer, faster, more efficient and more intuitive way and having as a result a more positive patient clinical outcome.
M Cerdan Torres
Lecture
5 years ago
217 views
3 likes
0 comments
05:10
Robotic surgery training center, a Brazilian experience
Introduction:
As there is no training protocol for robotic microsurgery established by Intuitive Surgical®, we chose to prepare a bibliographic revision about microsurgery training protocols, associating training with inanimate objects and practical training in biological material (animal model).
Methods:
A systematic review was performed crossing the words education and robotics using the PUBMED database. The search presented a result of 249 articles. We considered articles published in English over the past 10 years, having as a selection criteria for inclusion, the description of one of the following items: 1) techniques of teaching; 2) the learning curve or the training of basic principles of surgery as the basis of a training program; 19 published articles were eligible.
Discussion:
The possibility to adapt teaching techniques which are used in robotic laparoscopic videos and connecting theory with practice. The learning process has been organized in different levels of teaching.
Conclusion:
The fact that there are no recognized protocols for robotic microsurgery by Intuitive Surgical®, creates a necessity to develop teaching methodology standards for the robotic microsurgeon in order to be trained in a safer, faster, more efficient and more intuitive way and having as a result a more positive patient clinical outcome.
Robotic thoracoscopy: intercostal nerves and phrenic nerve harvesting
The aim of this study was to report the feasibility of robotic intercostal nerve harvesting in a pig model. A surgical robot (the da Vinci S® system, Intuitive Surgical, Sunnyvale, CA) was installed with three ports on the pig’s left chest. The posterior edges of the 4th, 5th, and 6th intercostal nerves were isolated to the level of the anterior axillary line. The anterior edges of the nerves were transected at the rib cartilage zone. Three intercostal nerve harvests were successfully performed in 40 minutes without major complications. The advantages of robotic microsurgery for intercostal nerve harvesting are motion scaling up to 5 times, elimination of physiological tremors, and free movement of joint-equipped robotic arms. Robot-assisted neurolysis may be clinically useful for intercostal nerve harvesting for brachial plexus reconstruction.
H Miyamoto
Lecture
5 years ago
152 views
5 likes
0 comments
06:07
Robotic thoracoscopy: intercostal nerves and phrenic nerve harvesting
The aim of this study was to report the feasibility of robotic intercostal nerve harvesting in a pig model. A surgical robot (the da Vinci S® system, Intuitive Surgical, Sunnyvale, CA) was installed with three ports on the pig’s left chest. The posterior edges of the 4th, 5th, and 6th intercostal nerves were isolated to the level of the anterior axillary line. The anterior edges of the nerves were transected at the rib cartilage zone. Three intercostal nerve harvests were successfully performed in 40 minutes without major complications. The advantages of robotic microsurgery for intercostal nerve harvesting are motion scaling up to 5 times, elimination of physiological tremors, and free movement of joint-equipped robotic arms. Robot-assisted neurolysis may be clinically useful for intercostal nerve harvesting for brachial plexus reconstruction.
Image-guided surgery: the augmented reality assistance
Medical imaging quality and accuracy of the human body (MRI, CT-scan, US, PET-scan) currently enable practitioners to establish a very precise diagnosis and to plan surgical interventions (open and laparoscopic surgery). Additionally, from CT-scan or MRI sections, the latest systems allow to display organs and pathological structures of patients in 3 dimensions, thereby facilitating the spatial understanding of practitioners. However, fully exploiting this precious information remains a challenge. In this presentation, the author explains how 3D patient model can be used to improve surgical planning. The author then describes how these 3D models can be brought to the operating room using augmented reality. Finally, the author provides an overview of the latest techniques about augmented reality guidance during minimally invasive surgery, and the main problems that still need to be overcome.
S Nicolau
Lecture
5 years ago
330 views
5 likes
0 comments
08:23
Image-guided surgery: the augmented reality assistance
Medical imaging quality and accuracy of the human body (MRI, CT-scan, US, PET-scan) currently enable practitioners to establish a very precise diagnosis and to plan surgical interventions (open and laparoscopic surgery). Additionally, from CT-scan or MRI sections, the latest systems allow to display organs and pathological structures of patients in 3 dimensions, thereby facilitating the spatial understanding of practitioners. However, fully exploiting this precious information remains a challenge. In this presentation, the author explains how 3D patient model can be used to improve surgical planning. The author then describes how these 3D models can be brought to the operating room using augmented reality. Finally, the author provides an overview of the latest techniques about augmented reality guidance during minimally invasive surgery, and the main problems that still need to be overcome.
Plastic and reconstructive robotic surgery: 5 cases and a systematic review
Introduction
We sought to determine the feasibility of robotic microvascular surgery in reconstructive surgery. Additionally, we performed a systematic review to assess the current developments in robotic plastic surgery.

Methods
Between February 2009 and June 2010, five patients underwent robotic microvascular anastomoses for delayed, free-tissue breast reconstruction, using the deep inferior epigastric artery (DIEP) flap. A PubMed and MEDLINE search was also performed using specific search terms.

Results
Mean patient age was 55.4 years. Mean robotic anastomotic time was 96 minutes. There were no additional errors of management (EOM). Figure 1 shows anastomotic times. No intraoperative or postoperative flap-related complications were encountered.
The literature search yielded 338 articles. Only 19 publications were relevant and further analyzed. The majority of authors report outcomes of microvascular surgery in laboratory conditions. Robotic microsurgery is accurate but consistently takes longer than with the microscope. Investigators consistently report poor haptic feedback.

Conclusion
Robotic microsurgery is safe in our experience. The current literature illustrates comparable vascular patency rates at the cost of longer operative times. Comparing robotic and standard microsurgery may be hampering the evolution of robotic plastic surgery because of this focus. The ability to perform microsurgery in confined anatomical spaces will reduce patient morbidity and potentially reduce in-patient stay. The ability to raise and inset flaps and explore neural and vascular structures, whilst avoiding large access wounds at both donor and recipient sites, is very attractive. Consequently, we believe that there any many reconstructive applications, and collaboration to produce meaningful clinical outcomes is required.
D Saleh
Lecture
5 years ago
361 views
16 likes
0 comments
10:28
Plastic and reconstructive robotic surgery: 5 cases and a systematic review
Introduction
We sought to determine the feasibility of robotic microvascular surgery in reconstructive surgery. Additionally, we performed a systematic review to assess the current developments in robotic plastic surgery.

Methods
Between February 2009 and June 2010, five patients underwent robotic microvascular anastomoses for delayed, free-tissue breast reconstruction, using the deep inferior epigastric artery (DIEP) flap. A PubMed and MEDLINE search was also performed using specific search terms.

Results
Mean patient age was 55.4 years. Mean robotic anastomotic time was 96 minutes. There were no additional errors of management (EOM). Figure 1 shows anastomotic times. No intraoperative or postoperative flap-related complications were encountered.
The literature search yielded 338 articles. Only 19 publications were relevant and further analyzed. The majority of authors report outcomes of microvascular surgery in laboratory conditions. Robotic microsurgery is accurate but consistently takes longer than with the microscope. Investigators consistently report poor haptic feedback.

Conclusion
Robotic microsurgery is safe in our experience. The current literature illustrates comparable vascular patency rates at the cost of longer operative times. Comparing robotic and standard microsurgery may be hampering the evolution of robotic plastic surgery because of this focus. The ability to perform microsurgery in confined anatomical spaces will reduce patient morbidity and potentially reduce in-patient stay. The ability to raise and inset flaps and explore neural and vascular structures, whilst avoiding large access wounds at both donor and recipient sites, is very attractive. Consequently, we believe that there any many reconstructive applications, and collaboration to produce meaningful clinical outcomes is required.
Functional reconstruction with motoneuron integrated striated muscles (MISM)
This study is made up of two parts. The first part is an animal experiment to develop a novel surgical technology named motoneuron-integrated striated muscles (MISM) technology. The second part is the introduction of a new human machine interface technology based on tacit learning. By combining the two advanced technologies, we have been trying to develop a future treatment for currently untreatable nerve palsies.
Re-innervation of denervated muscle by motoneurons transplanted into the peripheral nerve may provide the potential to excite muscles artificially with functional electrical stimulation (FES). We transplanted embryonic motoneurons into the peripheral nerve of adult Fischer 344 rats after transection of the sciatic nerve. One week after sciatic nerve transection, medium with or without dissociated embryonic spinal neurons was injected into the distal stump. Electrophysiological and tissue analyses were performed 12 weeks after transplant, as well as a naive control group which received no surgery. In the cell transplant group, the ankle angle was measured during gait with and without FES of the peroneal nerve. Transplanted motoneurons survived in the peripheral nerve and formed functional motor units. In the cell transplantation group, ankle angle at mid-swing was more flexed during gait with FES (26.6 ± 8.7°) than gait without FES (51.4 ± 12.8°, p=0.011), indicating that transplanted motoneurons in conjunction with FES restored ankle flexion in gait, even though no neural connection between central nervous system and muscle was present. These results indicate that transplant of embryonic motoneurons into peripheral nerve combined with FES can provide a new treatment strategy for paralyzed muscles. For the successful clinical application of MISM technology, the development of a human machine interface is key. We have developed a novel computer program, the tacit learning program, which can analyze patient intention and automatically adjust limb motion with minimum mental/physical burden on the human side. I am going to introduce a newly developed multi-degree of freedom electric-powered arm based on tacit learning to demonstrate the efficacy of the technology.
H Hirata
Lecture
5 years ago
173 views
5 likes
0 comments
12:07
Functional reconstruction with motoneuron integrated striated muscles (MISM)
This study is made up of two parts. The first part is an animal experiment to develop a novel surgical technology named motoneuron-integrated striated muscles (MISM) technology. The second part is the introduction of a new human machine interface technology based on tacit learning. By combining the two advanced technologies, we have been trying to develop a future treatment for currently untreatable nerve palsies.
Re-innervation of denervated muscle by motoneurons transplanted into the peripheral nerve may provide the potential to excite muscles artificially with functional electrical stimulation (FES). We transplanted embryonic motoneurons into the peripheral nerve of adult Fischer 344 rats after transection of the sciatic nerve. One week after sciatic nerve transection, medium with or without dissociated embryonic spinal neurons was injected into the distal stump. Electrophysiological and tissue analyses were performed 12 weeks after transplant, as well as a naive control group which received no surgery. In the cell transplant group, the ankle angle was measured during gait with and without FES of the peroneal nerve. Transplanted motoneurons survived in the peripheral nerve and formed functional motor units. In the cell transplantation group, ankle angle at mid-swing was more flexed during gait with FES (26.6 ± 8.7°) than gait without FES (51.4 ± 12.8°, p=0.011), indicating that transplanted motoneurons in conjunction with FES restored ankle flexion in gait, even though no neural connection between central nervous system and muscle was present. These results indicate that transplant of embryonic motoneurons into peripheral nerve combined with FES can provide a new treatment strategy for paralyzed muscles. For the successful clinical application of MISM technology, the development of a human machine interface is key. We have developed a novel computer program, the tacit learning program, which can analyze patient intention and automatically adjust limb motion with minimum mental/physical burden on the human side. I am going to introduce a newly developed multi-degree of freedom electric-powered arm based on tacit learning to demonstrate the efficacy of the technology.
Transaxillary first rib resection from an endoscopic concept to robotic technology, 30 years of experience
Introduction:
Our interest in minimally invasive vascular surgery dates back to 1982. We designed our endoscope, attached to a micro-video camera, making the transaxillary first rib and cervical band resection safer for the surgical treatment of disabling thoracic outlet syndrome. Over the following two decades, we evolved with the rapid technological development of minimally invasive surgery.

Material and methods:
644 total surgical procedures were performed between 1983 and 2013, including various stages. Video presentation of the “final product” in evolution during the past 10 years using the da Vinci® robotic system will be shown.

Results:
There were no mortalities, no permanent nerve, artery, or vein damage. The following could be noted: 8% complications, 4% respiratory, 3% temporary neurological dysfunctions, 0.8% infection, 0.4% transient renal insufficiency. Conversion rate was 1.1%, scar tissue formation of 0.4%, and length of stay: 3.3 days.

Conclusions:
The endoscopic transaxillary approach has helped us to understand the pathogenesis of the cervical bands frequently present in thoracic outlet syndrome. The procedure has evolved over the last 3 decades and the da Vinci® robotic system definitely offers great advantages, improving the surgical procedure and clinical outcome.
B Martinez
Lecture
5 years ago
336 views
7 likes
0 comments
14:10
Transaxillary first rib resection from an endoscopic concept to robotic technology, 30 years of experience
Introduction:
Our interest in minimally invasive vascular surgery dates back to 1982. We designed our endoscope, attached to a micro-video camera, making the transaxillary first rib and cervical band resection safer for the surgical treatment of disabling thoracic outlet syndrome. Over the following two decades, we evolved with the rapid technological development of minimally invasive surgery.

Material and methods:
644 total surgical procedures were performed between 1983 and 2013, including various stages. Video presentation of the “final product” in evolution during the past 10 years using the da Vinci® robotic system will be shown.

Results:
There were no mortalities, no permanent nerve, artery, or vein damage. The following could be noted: 8% complications, 4% respiratory, 3% temporary neurological dysfunctions, 0.8% infection, 0.4% transient renal insufficiency. Conversion rate was 1.1%, scar tissue formation of 0.4%, and length of stay: 3.3 days.

Conclusions:
The endoscopic transaxillary approach has helped us to understand the pathogenesis of the cervical bands frequently present in thoracic outlet syndrome. The procedure has evolved over the last 3 decades and the da Vinci® robotic system definitely offers great advantages, improving the surgical procedure and clinical outcome.
Use of Konnyaku Shirataki for robotic microsurgery training
The aim of this study was to test the potential implementation of a type of Japanese noodle, named konnyaku shirataki, for microsurgery training in the operating room.
Thirteen surgical residents without experience in microsurgery had to perform two microsurgical anastomoses: rat femoral artery model (control) and one on a konnyaku shirataki model. Two quantitative variables (time in minutes and number of stitches to perform the anastomosis) and two qualitative variables (patency and watertightness of the anastomosis) were measured. Sixty anastomoses were performed with the control model and 62 anastomoses with the konnyaku model. The time of the anatomosis was significantly higher in the control group. The number of stitches was similar in the 2 groups. Patency of the anastomosis was significantly lower in the control group. Watertightness of the anastomosis was significantly higher in the control group.
The konnyaku shirataki model, by its availability, low cost and close structure to the animal model could improve the teaching of microsurgery and tele-microsurgery (robotic microsurgery).
G Prunières
Lecture
5 years ago
286 views
6 likes
0 comments
07:54
Use of Konnyaku Shirataki for robotic microsurgery training
The aim of this study was to test the potential implementation of a type of Japanese noodle, named konnyaku shirataki, for microsurgery training in the operating room.
Thirteen surgical residents without experience in microsurgery had to perform two microsurgical anastomoses: rat femoral artery model (control) and one on a konnyaku shirataki model. Two quantitative variables (time in minutes and number of stitches to perform the anastomosis) and two qualitative variables (patency and watertightness of the anastomosis) were measured. Sixty anastomoses were performed with the control model and 62 anastomoses with the konnyaku model. The time of the anatomosis was significantly higher in the control group. The number of stitches was similar in the 2 groups. Patency of the anastomosis was significantly lower in the control group. Watertightness of the anastomosis was significantly higher in the control group.
The konnyaku shirataki model, by its availability, low cost and close structure to the animal model could improve the teaching of microsurgery and tele-microsurgery (robotic microsurgery).