J Reconstr Microsurg 2021; 37(06): 503-513
DOI: 10.1055/s-0040-1722183
Original Article

Robotic-Assisted Peripheral Nerve Surgery: A Systematic Review

1  Department of Plastic and Reconstructive Surgery, Linkou Medical Center and Chang-Gung University, School of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
Mei Goh
2  Department of Plastic and Reconstructive Surgery, Gold Coast University Hospital, Queensland, Australia
,
Raymond Goh
3  Valley Plastic Surgery, Queensland, Australia
,
Yin-Kai Chao
4  Division of Thoracic Surgery, Linkou Medical Center and Chang-Gung University, School of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
1  Department of Plastic and Reconstructive Surgery, Linkou Medical Center and Chang-Gung University, School of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
Wen-Ling Kuo
5  Division of Breast Surgery, Department of General Surgery, Chang Gung Memorial Hospital, Linkou and Taipei, Taiwan
,
Cheyenne Wei-Hsuan Sung
1  Department of Plastic and Reconstructive Surgery, Linkou Medical Center and Chang-Gung University, School of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
Johnny Chuieng-Yi Lu
1  Department of Plastic and Reconstructive Surgery, Linkou Medical Center and Chang-Gung University, School of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
David Chwei-Chin Chuang
1  Department of Plastic and Reconstructive Surgery, Linkou Medical Center and Chang-Gung University, School of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
,
Tommy Nai-Jen Chang
1  Department of Plastic and Reconstructive Surgery, Linkou Medical Center and Chang-Gung University, School of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
› Author Affiliations

Abstract

Background Robotic-assisted techniques are a tremendous revolution in modern surgery, and the advantages and indications were well discussed in different specialties. However, the use of robotic technique in plastic and reconstructive surgery is still very limited, especially in the field of peripheral nerve reconstruction. This study aims to identify current clinical applications for peripheral nerve reconstruction, and to evaluate the advantages and disadvantages to establish potential uses in the future.

Methods A review was conducted in the literatures from PubMed focusing on currently published robotic peripheral nerve intervention techniques. Eligible studies included related animal model, cadaveric and human studies. Reviews on robotic microsurgical technique unrelated to peripheral nerve intervention and non-English articles were excluded. The differences of wound assessment and nerve management between robotic-assisted and conventional approach were compared.

Results Total 19 studies including preclinical experimental researches and clinical reports were listed and classified into brachial plexus reconstruction, peripheral nerve tumors management, peripheral nerve decompression or repair, peripheral nerve harvesting, and sympathetic trunk reconstruction. There were three animal studies, four cadaveric studies, eight clinical series, and four studies demonstrating clinical, animal, or cadaveric studies simultaneously. In total 53 clinical cases, only 20 (37.7%) cases were successfully approached with minimal invasive and intervened robotically; 17 (32.1%) cases underwent conventional approach and the nerves were intervened robotically; 12 (22.6%) cases converted to open approach but still intervened the nerve by robot; and 4 (7.5%) cases failed to approach robotically and converted to open surgery entirely.

Conclusion Robotic-assisted surgery is still in the early stage in peripheral nerve surgery. We believe the use of the robotic system in this field will develop to become popular in the future, especially in the fields that need cooperation with other specialties to provide the solutions for challenging circumstances.



Publication History

Received: 05 June 2020

Accepted: 18 November 2020

Publication Date:
05 January 2021 (online)

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