Tristan Bourcier1, Jimmy Chammas2, Pierre-Henri Becmeur2, Arnaud Sauer2, David Gaucher2, Philippe Liverneaux2, Jacques Marescaux2, Didier Mutter2. 1. From the Department of Ophthalmology (Bourcier, Chammas, Becmeur, Sauer, Gaucher), the Department of Digestive and Robotic Surgery (Mutter, Marescaux), Institut de Recherche Contre les Cancers de l'Appareil Digestif-European Institute of Telesurgery (Marescaux, Mutter), Institut Hospitalo Universitaire, Institute of Image-Guided Surgery (Bourcier, Marescaux, Mutter), New Civil Hospital, the Department of Hand Surgery (Liverneaux), Centre de Chirurgie Orthopédique et de la Main, Illkirch, Strasbourg University Hospital, and Equipe d'Accueil 7290 (Bourcier, Chammas, Gaucher), Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France. Electronic address: tristan.bourcier@chru-strasbourg.fr. 2. From the Department of Ophthalmology (Bourcier, Chammas, Becmeur, Sauer, Gaucher), the Department of Digestive and Robotic Surgery (Mutter, Marescaux), Institut de Recherche Contre les Cancers de l'Appareil Digestif-European Institute of Telesurgery (Marescaux, Mutter), Institut Hospitalo Universitaire, Institute of Image-Guided Surgery (Bourcier, Marescaux, Mutter), New Civil Hospital, the Department of Hand Surgery (Liverneaux), Centre de Chirurgie Orthopédique et de la Main, Illkirch, Strasbourg University Hospital, and Equipe d'Accueil 7290 (Bourcier, Chammas, Gaucher), Fédération de Médecine Translationnelle de Strasbourg, University of Strasbourg, Strasbourg, France.
Abstract
PURPOSE: To evaluate the feasibility of robot-assisted simulated cataract surgery. SETTING: Institut de Recherche Contre les Cancers de l'Appareil Digestif, European Institute of Telesurgery, and Strasbourg University Hospital, Strasbourg, France. DESIGN: Experimental study. METHODS: Cataract surgeries were performed on a Kitaro cataract wet-lab training system simultaneously using the Da Vinci Xi robotic surgical system and the Whitestar Signature phacoemulsification system. For each procedure, the duration and successful completion of the surgery with or without ocular complications were assessed. RESULTS: Procedures were successfully performed on 25 lens nuclei. The feasibility of robot-assisted simulated cataract surgery was confirmed. The robotic surgical system provided the intraocular dexterity and operative field visualization necessary to perform the main steps of the phacoemulsification procedure; that is, corneal incisions, capsulorhexis, grooving, cracking, quadrant removal, and irrigation/aspiration of the ophthalmic viscosurgical device (OVD). The intervention of a second surgeon was required for the intraocular injections of OVD, balanced salt solution, and intraocular lenses. The mean operative time was 26.44 minutes ± 5.15 (SD). All lens nuclei were removed. Inadvertent enlargement of the main corneal incision caused by the phaco handpiece was observed in 2 cases. CONCLUSION: Experimental robot-assisted cataract surgery was technically feasible using the new robotic surgical system combined with a phacoemulsification machine.
PURPOSE: To evaluate the feasibility of robot-assisted simulated cataract surgery. SETTING: Institut de Recherche Contre les Cancers de l'Appareil Digestif, European Institute of Telesurgery, and Strasbourg University Hospital, Strasbourg, France. DESIGN: Experimental study. METHODS:Cataract surgeries were performed on a Kitaro cataract wet-lab training system simultaneously using the Da Vinci Xi robotic surgical system and the Whitestar Signature phacoemulsification system. For each procedure, the duration and successful completion of the surgery with or without ocular complications were assessed. RESULTS: Procedures were successfully performed on 25 lens nuclei. The feasibility of robot-assisted simulated cataract surgery was confirmed. The robotic surgical system provided the intraocular dexterity and operative field visualization necessary to perform the main steps of the phacoemulsification procedure; that is, corneal incisions, capsulorhexis, grooving, cracking, quadrant removal, and irrigation/aspiration of the ophthalmic viscosurgical device (OVD). The intervention of a second surgeon was required for the intraocular injections of OVD, balanced salt solution, and intraocular lenses. The mean operative time was 26.44 minutes ± 5.15 (SD). All lens nuclei were removed. Inadvertent enlargement of the main corneal incision caused by the phaco handpiece was observed in 2 cases. CONCLUSION: Experimental robot-assisted cataract surgery was technically feasible using the new robotic surgical system combined with a phacoemulsification machine.
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