Evidence map›Paper›PMID 39752076›Full record

ArticleJournal of robotic surgery2025

Implementation Strategies and Ergonomic Factors in Robot-assisted Microsurgery.

F Struebing, E Gazyakan, A K Bigdeli, F H Vollbach, J Weigel, U Kneser, A Boecker

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of robotic surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
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

7 authors.

F StruebingBG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
E GazyakanBG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
A K BigdeliBG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
F H VollbachBG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
J WeigelBG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
U KneserBG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
A BoeckerBG Trauma Center Ludwigshafen, Department for Plastic, Hand and Reconstructive Surgery, Department of Plastic Surgery for the Heidelberg University, Ludwig-Guttmann-Straße 13, 67071, Ludwigshafen, Germany. arnehendrik.boecker@bgu-ludwigshafen.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Robot-assisted surgery represents a significant innovation in reconstructive microsurgery, providing enhanced precision and reduced surgeon fatigue. This study examines the integration of robotic assistance in a series of 85 consecutive robot-assisted microsurgical (RAMS) operations. It aims to evaluate changes in the integration of RAMS during the implementation phase in a single institution. The study utilized a prospective database encompassing all robot-assisted microsurgical cases using the Symani surgical system from February until December 2023. A total of 85 robot-assisted operations were analyzed, showing a broad application across various types of reconstructive needs, predominantly in lower extremity repairs (n = 41). There were 68 free flap reconstructions (80.0%), ten nerve transfers (11.8%), four targeted muscle reinnervations (TMR; 4.7%), two lymphovenous anastomoses (2.4%) and one arterial reconstruction. The adoption of both traditional and digital exoscopic magnification systems was optimized for each surgical context. The operating room setup and infrastructural challenges for the different anatomic regions are presented. The introduction of robot-assisted surgery entailed overcoming challenges such as adapting to the lack of haptic feedback and navigating ergonomic constraints. Despite these hurdles, including higher operational costs and increased surgery durations, the precision and ergonomic benefits offered by robotic systems may be substantial. Potential solutions and tips to improve the operating times include frequent cleaning of the instruments, active surgical assistance, and rigorous presurgical planning of the logistical setup in the operating room. We showed that there is a preference for the utilization of digital exoscopes over conventional microscopes in RAMS, despite requiring more time per stitch when using the exoscope.

Indexed as

ErgonomicsMicrosurgeryRobotic Surgical ProceduresAdultAgedFemaleHumansMaleMiddle AgedOperating RoomsOperative TimePlastic Surgery ProceduresProspective StudiesFree Flap ReconstructionReconstructive SurgeryRobot-assisted MicrosurgeryRobotic MicrosurgeryRobotic SurgeryRobots in Plastic Surgery

Identifiers

PMID39752076
PMCPMC11698882

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.