J Reconstr Microsurg 2012; 28(07): 481-484
DOI: 10.1055/s-0032-1313760
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Robot-Assisted Free Toe Pulp Transfer: Feasibility Study

Nicolas Maire
1   Department of Hand Surgery, Strasbourg University Hospitals, Strasbourg, France
,
Kiyohito Naito
1   Department of Hand Surgery, Strasbourg University Hospitals, Strasbourg, France
2   Department of Orthopeadics, Juntendo University, Tokyo, Japan
,
Thierry Lequint
1   Department of Hand Surgery, Strasbourg University Hospitals, Strasbourg, France
3   Department of Orthopeadics, Grand Hôpital, Charleroi, Belgique, Belgium
,
Sybille Facca
1   Department of Hand Surgery, Strasbourg University Hospitals, Strasbourg, France
,
Stacey Berner
4   Department of Hand Surgery, Sinai Hospital Orthopaedic, Baltimore, Maryland
,
Philippe Liverneaux
1   Department of Hand Surgery, Strasbourg University Hospitals, Strasbourg, France
5   EITS, European Institute of TeleSurgery, Strasbourg, France
› Author Affiliations
Further Information

Publication History

07 October 2011

13 January 2012

Publication Date:
25 May 2012 (online)

Abstract

The current tendency of microsurgery is heading toward supermicrosurgery and microsurgery assisted by robotics. The aim of this work was to study the feasibility of a free hallux hemipulp transfer with a surgical robot in a cadaveric model. We used a human body. The intervention was realized by a Da Vinci SI® robot (Intuitive Surgical™, Sunnyvale, CA) in two stages: first taking off the medial hallux hemipulp, then transferring the hallux hemipulp to the radial thumb hemipulp. The intervention lasted 1 hour 59 minutes, exclusively with the Da Vinci SI® robot, without any interruption or outside intervention. Despite the absence of sensory feedback and an intervention 25% longer than in conventional microsurgery, we have demonstrated the feasibility of free hallux hemipulp transfer with a surgical robot. In the future, it is likely that the added benefits of the robot (physiological tremor suppression, user-friendly ergonomics, ultraprecise control of the instruments) will make the robot an indispensable tool for the surgeon.

 
  • References

  • 1 Buncke Jr HJ, Schulz WP. Experimental digital amputation and reimplantation. Plast Reconstr Surg 1965; 36: 62-70
  • 2 Davis JE. Toe-to-hand transfers (pedochyrodactyloplasty). Plast Reconstr Surg 1964; 33: 422-436
  • 3 Cobbett JR. Free digital transfer. Report of a case of transfer of a great toe to replace an amputated thumb. J Bone Joint Surg Br 1969; 51: 677-679
  • 4 Morrison WA, O'Brien BM, MacLeod AM. Thumb reconstruction with a free neurovascular wrap-around flap from the big toe. J Hand Surg Am 1980; 5: 575-583
  • 5 Buncke HJ. Toe digital transfer. Clin Plast Surg 1976; 3: 49-57
  • 6 Buncke HJ, Rose EH. Free toe-to-fingertip neurovascular flaps. Plast Reconstr Surg 1979; 63: 607-612
  • 7 Koshima I, Yamamoto T, Narushima M, Mihara M, Iida T. Perforator flaps and supermicrosurgery. Clin Plast Surg 2010; 37: 683-689 , vii–iii
  • 8 Kuroshima N. Modern technology-assisted microsurgery for innominate vessels. J Jpn Soc Reconstr Microsurg 2008; 21: 347-352
  • 9 Liverneaux P, Nectoux E, Taleb C. The future of robotics in hand surgery. Chir Main 2009; 28: 278-285
  • 10 Smith A, Smith J, Jayne DG. Telerobotics: surgery for the 21st century. Surgery 2006; 24: 74-78
  • 11 Selber JC. Transoral robotic reconstruction of oropharyngeal defects: a case series. Plast Reconstr Surg 2010; 126: 1978-1987
  • 12 Huart A, Facca S, Lebailly F, Garcia JC, Liverneaux PA. Are pedicled flaps feasible in robotic surgery? Report of an anatomical study of the kite flap in conventional surgery versus robotic surgery. Surg Innov 2011; 19 (1) 85-88
  • 13 Blavier A, Gaudissart Q, Cadière GB, Nyssen AS. Perceptual and instrumental impacts of robotic laparoscopy on surgical performance. Surg Endosc 2007; 21: 1875-1882
  • 14 Panchulidze I, Berner S, Mantovani G, Liverneaux P. Is haptic feedback necessary to microsurgical suturing? Comparative study of 9/0 and 10/0 knot tying operated by 24 surgeons. Hand Surg 2011; 16: 1-3
  • 15 van der Hulst R, Sawor J, Bouvy N. Microvascular anastomosis: is there a role for robotic surgery?. J Plast Reconstr Aesthet Surg 2007; 60: 101-102
  • 16 Elble RJ. Central mechanisms of tremor. J Clin Neurophysiol 1996; 13: 133-144
  • 17 Marescaux J, Leroy J, Gagner M , et al. Transatlantic robot-assisted telesurgery. Nature 2001; 413: 379-380
  • 18 Schencker PS, Das H, Ohm TR. A new robot for high dexterity microsurgery. In: Ayache N, ed. Computer Vision, Virtual Reality and Robotics in Medicine. Proceedings of Conference on Computer Vision, Virtual Reality. Berlin: Springer-Verlag; 1995: 15-22
  • 19 Koshima I, Inagawa K, Urushibara K, Moriguchi T. Supermicrosurgical lymphaticovenular anastomosis for the treatment of lymphedema in the upper extremities. J Reconstr Microsurg 2000; 16: 437-442
  • 20 Koshima I, Soeda S, Yamasaki M, Kyou J. The free or pedicled anteromedial thigh flap. Ann Plast Surg 1988; 21: 480-485