Robotic ocular surgery.

Abstract

BACKGROUND: Bimanual, three-dimensional robotic surgery has proved valuable for a variety of surgical procedures. AIMS: To examine the use of a commercially available surgical robot for ocular microsurgery. METHODS: Using a da Vinci surgical robot, ocular microsurgery was performed with repair of a corneal laceration in a porcine model. The experiments were performed on harvested porcine eyes placed in an anatomical position using a foam head on a standard operating room table. A video scope and two, 360 degrees -rotating, 8-mm, wrested-end effector instruments were placed over the eye with three robotic arms. The surgeon performed the actual procedures while positioned at a robotic system console that was located across the operating room suite. Each surgeon placed three 10-0 sutures, and this was documented with still and video photography. RESULTS: Ocular microsurgery was successfully performed using the da Vinci surgical robot. The robotic system provided excellent visualisation, as well as controlled and delicate placement of the sutures at the corneal level. CONCLUSIONS: Robotic ocular microsurgery is technically feasible in the porcine model and warrants consideration for evaluation in controlled human trials to deploy functioning remote surgical centres in areas without access to state-of-the-art surgical skill and technology.