Advertisement

Robot Installation in Telemicrosurgery

  • Thierry Lequint
  • Kiyohito Naito
  • Eric Nectoux
  • Sybille Facca
  • Philippe LiverneauxEmail author
Chapter

Abstract

Telemicrosurgery requires specific installation, completely different than in conventional microsurgery: robot position with regard to both the patient and the surgeon, surgical approaches, dissection of and support of a convenient surgical cavity allowing enough space for both camera and surgical instruments to move unimpeded.

Installation of the microscope is far easier in conventional microsurgery than in robot in telemicrosurgery. In telemicrosurgery, the arms of the robot do not extend significantly beyond the robot’s body, but are aimed instead towards the body. The body of the robot needs to be installed facing the telemicrosurgeon, as if the robot was about to perform a conventional microsurgical procedure.

Telemicrosurgery can be performed either by open approach or by minimally invasive means. Using a conventional open approach, telemicrosurgery does not require any alteration in routine other than robot installation. Minimally invasive telemicrosurgery limits the potential for scar tissue formation. Surgical approaches and indications are subject to the same requirements as in conventional laparoscopic telesurgery. In telemicrosurgery, the surgical field is located inside a cavity which needs to be at first dissected and then maintained during the procedure.

Installation of a telemicrosurgical procedure is complex, and adherence to several principles is warranted.

References

  1. 1.
    Ali MR, Rasmussen J, Bhasker Rao B (2007) Teaching robotic surgery: a stepwise approach. Surg Endosc 21:912–915PubMedCrossRefGoogle Scholar
  2. 2.
    Chan W, Niranjan N, Ramakrishnan V (2010) Structured assessment of microsurgery skills in the clinical setting. J Plast Reconstr Aesthet Surg 63:1329–1334PubMedCrossRefGoogle Scholar
  3. 3.
    Dexter SPL, Vucevic M, Gibson J, McMahon MJ (1999) Hemodynamic consequences of high- and low-pressure capnoperitoneum during laparoscopic cholecystectomy. Surg Endosc 13:376–381PubMedCrossRefGoogle Scholar
  4. 4.
    Evans BC, Evans GR (2007) Microvascular surgery. Plast Reconstr Surg 119:18–30CrossRefGoogle Scholar
  5. 5.
    Facca S, Liverneaux P (2010) Robotic assisted microsurgery in hypothenar hammer syndrome: a case report. Comput Aided Surg 15:110–114PubMedCrossRefGoogle Scholar
  6. 6.
    Garcia JC Jr, Mantovani G, Gouzou S, Liverneaux P (2011) Telerobotic anterior translocation of the ulnar nerve. J Robotic Surg 5:153–156CrossRefGoogle Scholar
  7. 7.
    Guldmann R, Pourtales MC, Liverneaux P (2010) Is it possible to use robots for carpal tunnel release? A case report. J Orthop Sci 15:430–433PubMedCrossRefGoogle Scholar
  8. 8.
    Jacobs VR, Morrison JE Jr (2007) The real intraabdominal pressure during laparoscopy: ­comparison of different insufflators. J Minim Invasive Gynecol 14:103–107PubMedCrossRefGoogle Scholar
  9. 9.
    Kang SW, Lee SC, Lee SH, Lee KY, Jeong JJ, Lee YS, Nam KH, Chang HS, Chung WY, Park CS (2007) Robotic thyroid surgery using a gasless, transaxillary approach and the da Vinci S system: the operative outcomes of 338 consecutive patients. Surgery 146:1048–1055CrossRefGoogle Scholar
  10. 10.
    Lebailly F, Facca S, Bednar M, Mantovani G, Berner S, Liverneaux P (2010) Robotic surgery around shoulder girdle. In: Allieu Y (ed) Shoulder girdle. Sauramps Medical, Montpellier, pp 239–246Google Scholar
  11. 11.
    Liverneaux P, Nectoux E, Taleb C (2009) The future of robotics in hand surgery. Chir Main 28:278–285PubMedCrossRefGoogle Scholar
  12. 12.
    Mantovani G, Liverneaux P, Berner S, Bednar M, Mohr C (2011) Endoscopic exploration and repair of brachial plexus with tele-robotic manipulation: a cadaver trial. J Neurosurg 8:1–6Google Scholar
  13. 13.
    Naito K, Facca S, Lequint T, Liverneaux P (2011) Oberlin’s procedure for restoration of elbow flexion with Da Vinci robot: 4 cases. Plast Reconstruct Surg 129(3):707–711Google Scholar
  14. 14.
    Neuhaus SJ, Gupta A, Watson DI (2001) Helium and other alternative insufflation gases for laparoscopy. Surg Endosc 15:553–560PubMedCrossRefGoogle Scholar
  15. 15.
    Zobrist R, Aponte RL, Levin LS (2002) Endoscopic access to the extremities: the principle of fascial clefts. J Orthop Trauma 16:264–271PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • Thierry Lequint
    • 1
    • 2
  • Kiyohito Naito
    • 1
    • 3
  • Eric Nectoux
    • 4
    • 5
  • Sybille Facca
    • 1
  • Philippe Liverneaux
    • 1
    • 4
    Email author
  1. 1.Department of Hand SurgeryStrasbourg University HospitalsIllkirch, StrasbourgFrance
  2. 2.Department of OrthopeadicsGrand HôpitalCharleroiBelgium
  3. 3.Department of OrthopeadicsJuntendo UniversityTokyoJapan
  4. 4.European Institute of TeleSurgery, IRCADStrasbourgFrance
  5. 5.Department of Children’s Surgery and OrthopaedicsLille University Hospital, Lille 2 Nord de France UniversityLilleFrance

Personalised recommendations