ROBOTICALLY ASSISTED LAPAROSCOPIC MICROSURGICAL UTERINE HORN ANASTOMOSIS

Objective: To evaluate the feasibility, safety, and sterility issues w ith regard to the use of a robotic device to perform uterine horn anas tomosis in a live porcine model. Design: Prospective animal study. Set ting: Landrace-Yorkshire pigs in a conventional laboratory setting. In tervention(s): Six female pigs underwent laparoscopic bipolar electroc oagulation of the distal uterine horns. Two weeks later, the uterine h orns were reanastomosed laparoscopically with use of a robotic system for microsuturing. Necropsy was performed 4 weeks later to assess post operative adhesions and anastomosis patency. Main Outcome Measure(s): Tubal patency; secondary measures were operative time, complications, and surgeon fatigue. Result(s): The mean(+/- SD) total operative time per animal was 170 +/- 34 minutes including setting up and dismantling the robotic arms. The robot functioned well with only minor technical problems. All pigs survived both surgeries with no perioperative comp lications related to the use of the robot. Patency was confirmed after completing each anastomosis (12 anastomoses: 100% patency). Four week s later, necropsy showed that eight anastomoses were still patent (67% ). Only one pig had bilateral occlusion. Surgeon's fatigue was mild fo r each animal study. Conclusion(s): Robotic technology can be used saf ely in creating laparoscopic microsurgical anastomoses. The robot func tioned properly in a sterile operating room environment. Adequate pate ncy rates were achieved during the acute phase and at 4-week follow-up . Robotic technology has the potential to make laparoscopic microsutur ing easier. (Fertil Steril(R) 1998;70:530-4. (C) 1998 by American Soci ety for Reproductive Medicine.).