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Robotic microsurgery and the future

Epublication WebSurg.com, Jun 2014;14(06). URL: http://websurg.com/doi/lt03enparekattil001

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  • 2014-06-12
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Vasectomy is one of the most common urological procedures in the United States. Each year approximately five hundred thousand men undergo vasectomy. However, up to 6% of these patients desire a vasectomy reversal at some point in their lives in order to regain fertility. Vasectomy reversal is a challenging microsurgical procedure that requires re-anastomosis of the transected vas deferens using 9/0 and 10/0 sutures. Chronic groin or scrotal content pain is another entity that affects up to 100,000 patients annually. Targeted microsurgical denervation of the spermatic cord is a viable option for this condition. This presentation covers our work on the use of a robotic assisted microsurgical platform in over 1,000 such procedures. The use of robotics for microsurgery may provide advantages in terms of multi-view magnification, motion scaling, elimination of tremor, and additional surgical arms in a stable ergonomic platform. The additional fourth arm can improve surgeon efficiency (provides an extra microsurgical instrument handled simultaneously with less reliance on a skilled microsurgical assistant). Previously, we could perform only two standard microsurgical procedures a day due to surgeon fatigue limitations using the standard microscope. With the aid of the robotic system, the same microsurgeon has been able to routinely perform up to 4-5 microsurgical procedures a day due to the ergonomic advantages of the robot. Robotics may also help to inspire our youth and operating room staff and help to motivate their interest in our field. We also present collaborative programs to achieve these goals: a collegiate high-school program developed with Polk State College to engage our youth to pursue science and engineering careers, and a robotic nurse training credentialing program.