Mihara Makoto, Hara Hisako, Wakana Kazuhito, Owaki Hirofumi, Mikami Kei, Miyamoto Atsushi, Naito Munekazu, Masamune Ken
From the Mukumi Clinic, Lymphedema clinic Tokyo, Tokyo, Japan.
Department of Lymphatic and Reconstructive Surgery, JR Tokyo General Hospital, Tokyo, Japan.
Plast Reconstr Surg Glob Open. 2025 Sep 10;13(9):e7072. doi: 10.1097/GOX.0000000000007072. eCollection 2025 Sep.
Microsurgery requires high precision, stability, and effective teamwork. However, current robotic-assisted surgery faces challenges such as inefficient instrument exchange and dependence on surgical assistants, contributing to prolonged operative times and increased costs. To address these issues and enhance surgical efficiency and surgeon autonomy, we developed a microsurgery-assisting robot equipped with an automated instrument exchange system and a specialized micro tool kit. The robot was tested using chicken-wing arteries and rat vessels with diameters ranging from 0.35 to 0.8 mm. Evaluation parameters included anastomosis time, frequency of instrument exchanges, and vascular patency rates. The automated system completed instrument exchanges accurately within approximately 9 seconds, maintaining a smooth workflow while significantly reducing reliance on assistants. In the rat model, a vascular patency rate of 100% was achieved. Although anastomosis times were slightly longer compared with manual operations performed by skilled surgeons, our system is anticipated to improve accuracy in complex microsurgical procedures involving extremely fine vessels. Conventional microsurgery-assisting robots have primarily focused on performing vascular anastomosis alone; however, our newly developed robot with an automated instrument exchange mechanism effectively facilitates a broader range of tasks, including vessel dissection, trimming, vascular anastomosis, and postoperative patency assessments.
显微外科手术需要高精度、稳定性和高效的团队协作。然而，当前的机器人辅助手术面临着诸如器械更换效率低下以及依赖手术助手等挑战，这导致手术时间延长和成本增加。为了解决这些问题并提高手术效率和外科医生的自主性，我们开发了一种配备自动器械更换系统和专用微型工具套件的显微手术辅助机器人。该机器人使用直径范围为0.35至0.8毫米的鸡翅动脉和大鼠血管进行了测试。评估参数包括吻合时间、器械更换频率和血管通畅率。自动系统在大约9秒内准确完成器械更换，保持了流畅的工作流程，同时显著减少了对助手的依赖。在大鼠模型中，血管通畅率达到了100%。尽管与熟练外科医生进行的手动操作相比，吻合时间略长，但我们的系统有望提高涉及极细血管的复杂显微手术的准确性。传统的显微手术辅助机器人主要专注于单独进行血管吻合；然而，我们新开发的具有自动器械更换机制的机器人有效地促进了更广泛的任务，包括血管解剖、修剪、血管吻合和术后通畅性评估。
