Enabling non-microsurgeons to perform supermicrovascular anastomosis using a robotic assistant: A preclinical study

Supermicrosurgery is an advanced technique that enables the reconstruction and transplantation of tissues by anastomosing blood vessels and nerves measuring 0.3–0.8 mm in diameter using specialized microscopes. This intricate procedure is mastered by only a select few plastic surgeons. However, the potential applications of this technology are widespread, including reconstructive surgery after resection of malignant tumors, organ transplantation, and treatment of lymphedema; therefore, more surgeons need to learn such procedures. This study demonstrated that novice operators without prior experience in robotic surgery—including some who had never performed suturing—were able to perform supermicrovascular anastomosis in vivo within a short period using a surgical assistant robot. During the robot’s development, emphasis was placed on reducing the difficulty of surgeon’s tasks, utilizing prior experience, enabling intuitive operation, and maintaining concentration. Twelve novice operators successfully performed anastomosis of a 0.6-mm rat femoral artery after a mean training time of 2 h 38 min. The mean operative time was 1 h 27 min, with patency rates of 75% on gross evaluation and 83.3% on histologic assessment. Robotic assistance is expected to facilitate the widespread adoption of supermicrosurgery. It has the potential to transform surgical practices and benefit more patients in the future.