Robotics in Plastic and Reconstructive Surgery

This book describes the current state of robotics in plastic and reconstructive surgery. It examines existing clinical applications, emerging and future applications and evolving technological platforms. Concise yet comprehensive, this book is organized into four sections. It begins with an introduction to robotic microsurgical training and robotic skills assessment, including crowd-sourced evaluation in surgery. Section two explores a variety of robotic clinical application, including robotic breast reconstruction, robotic mastectomy, robotic cleft palate surgery and robotic microsurgery in a urologic private practice. Following this, section three addresses the opportunities and challenges an interested surgeon might face when considering incorporating this technology into their practice. To close, the final section discusses new microsurgical robotic platforms and the potential directions this technology may take in the future. Supplemented with high quality videos and images, __Robotics in Plastic and Reconstructive Surgery__ is an invaluable resource for both plastic surgeons and multi-specialty micro-surgeons. Preface Contents Contributors Part I: Training and Evaluation 1: Robotic Microsurgical Training Microsurgery Teaching Methods Assessment of Microsurgery and Robotic Microsurgery Skill Acquisition Simulation Models Learning Curves in Microsurgery References 2: Robotic Skills Assessment: Crowd-Sourced Evaluation in Surgery and Future Directions in Plastic Surgery Introduction The Current State of Assessment in Surgical Education Credentialing Objective Structured Assessment Barriers to OSATS Crowd-Sourced Assessment of Technical Skills (CSATS) Dry-Lab Validation Relevant Surgery Skills Validation Barriers to Adoption of a CSATS Methodology to Robotic Microsurgical Procedures in Plastic Surgery Conclusion References Part II: Clinical Applications 3: Robotic Harvest of the Rectus Abdominis Muscle Introduction Flap Anatomy Indications and Contraindications for Robotic-Assisted Rectus Harvest Advantages Disadvantages Surgical Technique Patient Positioning Docking and Port Placement Instruments and Positioning Flap Harvest Urologic Indications and Pelvic Inset (for Pedicled Flaps) Postoperative Care Outcomes Case Examples Pearls and Pitfalls References Selected Reading 4: Robotic Breast Reconstruction with the Latissimus Dorsi Flap Introduction Anatomy Patient Selection Preoperative Planning and/or Patient Preparation Surgical Technique Postoperative Care Clinical Cases and Outcomes Conclusion References 5: The RoboDIEP: Robotic-Assisted Deep Inferior Epigastric Perforator Flaps for Breast Reconstruction Introduction Patient Selection Technique Discussion Conclusion References 6: Robotic Nerve and Upper Extremity Surgery Introduction Clinical Case Conclusion References 7: Robotic Cleft Palate Surgery and Simulation Introduction The Challenges of Performing Cleft Palate Surgery The Potential Advantages of Using a Robot for Cleft Palate Repair Cleft Palate Simulator Test Bed Simulators as Test Beds for Developing Robotic Surgical Approaches Trans-oral Robotic Surgery (TORS) The da Vinci Surgical System The Limitations of the da Vinci for TORS Robotic Cleft Palate Repair Pre-clinical Studies Clinical Studies Robotic Platforms and Instruments for Infant Cleft Palate Surgery Overall System Architecture Articulating Surgical Wrist Mechanisms Requirements for Infant Cleft Palate Surgery Robotic Instruments New Instrument Design Conclusions and Future Directions References 8: Robotic Microsurgery in Urology Private Practice: Advantages and Outcomes Introduction Robotic Microsurgical Vasovasostomy (RMVV) Robotic-Assisted Microsurgical Varicocelectomy (RAVx) Microsurgical Denervation of Spermatic Cord Procedure Outcomes References 9: Robotic Nipple-Sparing Mastectomy with Immediate Prosthetic Breast Reconstruction Introduction Advantages of Robotic Assistance in Nipple-Sparing Mastectomy Patient Selection Preoperative Drawings Surgical Technique Results (Figs. 9.8, 9.9, 9.10, 9.11, 9.12, 9.13, 9.14, 9.15, 9.16, 9.17, 9.18, 9.19, 9.20, 9.21, and 9.22) Conclusion References Part III: Considerations for a Robotic Plastic Surgery Practice 10: Incorporating Robotics into a Plastic Surgery Practice Benefits of Robotic Plastic Surgery Feasibility of a Robotic Practice (US Perspective) Feasibility of a Robotic Practice (International Perspective) Practical Approach to Starting the Robotic Practice Future Challenges References Part IV: New Microsurgical Robotic Platforms 11: Development of a New Robotic Platform for Microsurgery Robotic Systems for Microsurgery User Requirements and Design Inputs for Microsurgical Robotic Systems References 12: A Dedicated Robotic System for Open (Super-)Microsurgery Introduction Robotic Platforms A New Robotic Platform for Microsurgery Preclinical Experience First Commercially Available Robot for Microsurgery: MUSA First-in-Human Robot-Assisted Supermicrosurgery Other Novel Robotic Platforms Robotic Microsurgical Applications Cardiac Surgery Transoral Surgery and Otolaryngology Ophthalmology Neurosurgery Urology Plastic and Reconstructive Microsurgery Super-Microsurgery Discussion – Future Directions Conclusion References Index