Full robotic assistance for laparoscopic tubal anastomosis: A case report

Optical magnification and long instrumentation significantly increase surgi cal tremor, which makes laparoscopic microsuturing difficult. Therefore, la paroscopic tubal anastomosis has not gained wide acceptance among gynecolog ic surgeons. Robotic assistance facilitates this type of procedure by filte ring tremor, reducing the surgeon's fatigue, and scaling the maneuvers. The authors have successfully completed a case of laparoscopic tubal reanastom osis using a "master-slave" robot to perform the standard microsuturing tec hnique. A 33-year-old woman, gravida 2, para 2, requested reversal of her p revious tubal ligature. A right isthmic-isthmic tubal anastomosis was perfo rmed laparoscopically, with faithful adherence to the authors' standard tec hnique applied at laparotomy. Full robotic assistance was used to anastomos e the tube. A chromotubation test showed anastomotic patency without leak. The patient recovered uneventfully after surgery and was discharged within 24 h after the procedure. Laparoscopic microsurgical tubal anastomosis with full robotic assistance is feasible and safe in humans.