Bourges J-L, Hubschman J-P, Burt B, Culjat M, Schwartz S D
Jules Stein Eye Institute, UCLA, 100 Stein Plaza, Los Angeles, CA 90095, USA.
Br J Ophthalmol. 2009 Dec;93(12):1672-5. doi: 10.1136/bjo.2009.157594.
Robotic ocular microsurgery including corneal suturing has been proven to be feasible in porcine eyes.
To determine whether or not bimanual teleoperated robotic penetrating keratoplasty (PK) can be performed in porcine and human eyes.
Three arms of the da Vinci surgical robot were loaded with a dual-channel video and two, 360 degrees -rotating, 8 mm, wrested-end effector instruments and placed over porcine eyes or over a human cadaver head. The surgeon remotely performed mechanical trephination, cardinal sutures, continuous 10.0 nylon sutures and suture adjustments on both eyes. The procedures were documented with still and video photography.
Using the da Vinci robot, penetrating keratoplasty procedures were successfully performed on both porcine eyes and human eyes in natural anatomical conditions. The precise placement of continuous sutures was facilitated by the wrested-end forceps. Orbital rims and nose did not limit surgical motions.
Teleoperated robotic penetrating keratoplasty is technically feasible in humans. Further studies are pending to implement the procedure with femtosecond laser and other automated steps.
包括角膜缝合在内的机器人眼显微手术已被证明在猪眼中是可行的。
确定双手机器人穿透性角膜移植术（PK）是否能在猪眼和人眼中进行。
达芬奇手术机器人的三个臂加载了双通道视频以及两个360度旋转、8毫米、带扭转末端的手术器械，并放置在猪眼或人类尸体头部上方。外科医生远程对双眼进行机械环钻、定位缝合、连续10.0尼龙缝合和缝线调整。手术过程通过静态照片和视频记录。
使用达芬奇机器人，在自然解剖条件下，猪眼和人眼均成功完成穿透性角膜移植手术。扭转末端镊子便于连续缝线的精确放置。眼眶边缘和鼻子不限制手术动作。
远程操作机器人穿透性角膜移植术在人体上技术上是可行的。有待进一步研究以应用飞秒激光和其他自动化步骤来实施该手术。
