Robotically assisted laparoscopic microsurgical tubal reanastomosis: a feasibility study

Objective: To assess the feasibility and reproducibility of laparoscopic mi crosurgical tubal anastomosis using a remote-controlled robot. Design: Descriptive case study. Setting: Academic medical center. Patient(s): Eight patients with previous laparoscopic tubal sterilization w ho requested tubal reanastomosis. Intervention(s): Systematization of the o perative steps for laparoscopic tubal reanastomosis using a remote-controll ed robot. Main Outcome Measure(s): Primary outcome measures were feasibility and repr oducibility; secondary measures were tubal patency, operative time, complic ations, and ergonomic qualities. Result(s): The 16 tubes were successfully reanastomosed and patency was con firmed, The mean time that the robotic system was in use was 140 minutes, a nd mean surgical time was 52 minutes per tube. Conclusion(s): Laparoscopic microsurgical tubal reanastomosis after tubal s terilization can be performed using a remote-controlled robotic system. The robot, which has three-dimensional vision, allows the surgeon to perform u ltraprecise manipulations with intraabdominal articulated instruments while providing the necessary degrees of freedom. Systematization of the operati ve steps allowed performance of the operation at a Speed that compares favo rably with the time needed for open microsurgical techniques. Larger series are needed to assess postoperative pregnancy rates. (Fertil Steril(R) 2000 ;74:1020-2. (C) 2000 by American Society for Reproductive Medicine.).