Evidence map›Paper›PMID 38948156›Full record

ArticlePlastic and reconstructive surgery. Global open2024

Robot-assisted Microsurgery: Lessons Learned from 50 Consecutive Cases.

Felix Struebing, Amir Bigdeli, Jonathan Weigel, Emre Gazyakan, Felix Vollbach, Adriana C Panayi, Julian Vogelpohl, Arne Boecker, Ulrich Kneser

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Plastic and reconstructive surgery. Global open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

20 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Felix StruebingFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Amir BigdeliFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Jonathan WeigelFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Emre GazyakanFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Felix VollbachFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Adriana C PanayiFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Julian VogelpohlFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Arne BoeckerFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.
Ulrich KneserFrom the BG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the University of Heidelberg, Ludwigshafen, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The potential of robot-assisted surgery in plastic and reconstructive surgery remains to be established, especially in free tissue transfer. This prospective study aimed to present our experience and findings from the first 50 consecutive cases of robot-assisted microsurgery using the Symani surgical system. Methods: A prospective database was maintained, recording patient demographics and surgical details for all cases of robot-assisted microsurgery in a large academic institution. All surgeons underwent an intensive training program with the Symani surgical system. Results: A total of 50 patients who underwent robot-assisted microsurgical reconstruction were identified. Free microsurgical tissue transfer was performed in 45 cases, targeted muscle reinnervation in four cases, and lymphovenous anastomoses in a single case. A total of 94 robot-assisted anastomoses and coaptations were performed, (46 venous and 30 arterial anastomoses, 16 nerve coaptations, two lymphovenous anastomoses). Six cases involved perforator-to-perforator anastomoses. Ninety-eight percent of attempted anastomoses were completed using the robot. Size-mismatch anastomoses, seen in 37.8% of cases, took significantly longer. Minor complications occurred in three cases and major in six cases. There were three cases of microvascular compromise requiring revision. One partial flap loss and no complete flap loss occurred. Conclusions: Our study highlights the immense potential of robot-assisted microsurgery, and a feasible and effective modality for various microsurgical procedures, with outcomes comparable to those of conventional microsurgery. Despite challenges, such as increased operating times and higher costs, the technology offers significant advantages, such as enhanced precision and motion scaling. We identify a slow learning curve and a necessity for higher caseloads.

Identifiers

PMID38948156
PMCPMC11213613

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.