ROBOTICALLY ASSISTED LAPAROSCOPIC TUBAL ANASTOMOSIS IN A PORCINE MODEL - A PILOT-STUDY

As with standard microsurgical procedures performed at laparotomy, lap aroscopic tubal anastomosis requires great dexterity. Handling fine su ture materials under magnification to anastomose tubal segments with l umens less than 3 mm in diameter while working with your hands at a di stance from the tissue makes these fine movements even more difficult. This is exacerbated by the tremor induced by the fatigue caused by a prolonged laparoscopic procedure and the need for precise control. We conducted a pilot study to evaluate the feasibility of performing lapa roscopic tubal anastomosis with robotic assistance in a live porcine m odel. Two anastomoses mere performed on one uterine horn via each of t he following techniques: laparoscopy, laparoscopy with robotic assista nce, and open microsurgery. Immediate necropsy demonstrated all the an astomoses to be patent. There were no intraoperative complications. La paroscopic tubal anastomosis was associated with surgeon fatigue and n eck, shoulder, and back pain. The surgeons were more comfortable perfo rming the procedure with robotic assistance. The device functioned wel l and without incident. This acute animal study suggests that robotic assistance in laparoscopic tubal anastomoses is safe and feasible. It enhances surgeons' dexterity and precision while reducing fatigue. It is promising for future use in chronic experimental studies.