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Nerves

  • Stacey H. BernerEmail author
Chapter

Abstract

Neural tissue is amongst the most difficult tissue to operate on, since it requires mastership of microsurgical techniques prior to acquiring robotic skills. This may represent a real triumph of telemanipulators, as they facilitate the microsurgical step. The goals of the training programs are to build facility with the robot and to provide an opportunity to simulate an in-vivo or “live” surgical procedure. Currently, there is not an adequate synthetic substitute or training model for Nerve surgery and Microneural Repair. As such, the surgeon interested in learning the skill of Robot assisted Nerve Repair requires training on animal and cadaver tissue. Clinical applications may include neurolysis of the Brachial Plexus, nerve decompression in the upper or lower extremity, neurectomy for treatment of spasticity, and translocation of neuromata. Advanced robotic training may utilize the endoscopic capabilities of the telemanipulator to perform minimally invasive nerve repair. Once facility has been achieved in the lab, transition to the clinical setting can be rewarding. Training protocols will continue to evolve and become standardized as this emerging discipline grows.

Keywords

Brachial Plexus Training Protocol Haptical Feedback Nerve Repair Nerve Decompression 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. 1.
    Cotin S, Delingette H, Ayache N (2000) A hybrid elastic model allowing realtime cutting, deformation and force-feedback for surgery training and simulation. Vis Comp J 16:437–452CrossRefGoogle Scholar
  2. 2.
    Garcia JC Jr, Mantovani G, Gouzou S et al (2011) Telerobotic anterior translocation of the ulnar nerve. J Robot Surg 5:153–156CrossRefGoogle Scholar
  3. 3.
    Guldmann R, Pourtales MC, Liverneaux P (2010) Is it possible to use robots for carpal tunnel release? J Orthop Sci 15:430–433PubMedCrossRefGoogle Scholar
  4. 4.
    Liverneaux P, Nectoux E, Taleb C (2009) The future of robotics in hand surgery. Chir Main 28:278–285PubMedCrossRefGoogle Scholar
  5. 5.
    Mantovani G, Liverneaux P, Garcia JC et al (2011) Endoscopic exploration and repair of brachial plexus with tele-robotic manipulation: a cadaver trial. J Neurosurg 8:1–6Google Scholar
  6. 6.
    Panchulidze I, Berner S, Mantovani G et al (2011) Is haptic feedback necessary to microsurgical suturing? A comparative study of 9/0 and 10/0knot tying operated by 24 surgeons. Hand Surg 16:1–3PubMedCrossRefGoogle Scholar
  7. 7.
    Taleb C, Nectoux E, Liverneaux P (2009) Limb replantation with two robots: a feasibility study in a pig model. Microsurgery 29:232–235PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryNorthwest HospitalOwings Mills, BaltimoreUSA

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