Robotically assisted laparoscopic microsurgical tubal reanastomosis: a feasibility study

Abstract

Objective: To assess the feasibility and reproducibility of laparoscopic microsurgical tubal anastomosis using a remote-controlled robot. Design: Descriptive case study. Setting: Academic medical center. Patient(s): Eight patients with previous laparoscopic tubal sterilization who requested tubal reanastomosis. Intervention(s): Systematization of the operative steps for laparoscopic tubal reanastomosis using a remote-controlled robot. Main Outcome Measure(s): Primary outcome measures were feasibility and reproducibility; secondary measures were tubal patency, operative time, complications, and ergonomic qualities. Result(s): The 16 tubes were successfully reanastomosed and patency was confirmed. The mean time that the robotic system was in use was 140 minutes, and mean surgical time was 52 minutes per tube. Conclusion(s): Laparoscopic microsurgical tubal reanastomosis after tubal sterilization can be performed using a remote-controlled robotic system. The robot, which has three-dimensional vision, allows the surgeon to perform ultraprecise manipulations with intraabdominal articulated instruments while providing the necessary degrees of freedom. Systematization of the operative steps allowed performance of the operation at a speed that compares favorably with the time needed for open microsurgical techniques. Larger series are needed to assess postoperative pregnancy rates.