Journal of Robotic Surgery

Performance of microvascular anastomosis with a new robotic visualization system

The article “Performance of microvascular anastomosis with a new robotic visualization system” was published in the Journal of Robotic Surgery in August 2021. The authors (Boehm F et al., 2021) present and proof the feasibility of the surgical reconstructive therapy of head and neck cancer with the application of the RoboticScope®.


The RoboticScope® was used in microvascular procedures where high resolution visualization of the surgical field is necessary. In a first step, coronary artery anastomoses of ex vivo pig hearts were performed. Second, a radial forearm free flap was completed in a clinical setting/in vivo.


One of the main advantages of the RoboticScope in comparison to a conventional microscope was that the system enabled a neutral and upright posture of the spine during the whole surgery rather than a bent-over position.

Boehm F et al., 2021

The overall impression of the application of the RoboticScope® in reconstructive microvascular surgery of the head and neck was promising. As a result, several advantages were stated by the authors, including feasibility and visualization. Favorable ergonomics being highlighted as the main benefit. According to the authors, the system enables a neutral, upright position during the whole procedure which can thus reduce the risk for cervical musculoskeletal pain or long-term degenerative changes in the cervical spine.

Another positive point relates to the financial benefits of the device. It is mentioned that the running costs are very low as no special instruments are necessary and it only requires the usage of a sterile drape. Also, the operating time was comparable to the time using a conventional microscope. The patient’s outcome was good and no intra- or postoperative complications occurred.

The ergonomic assessment questionnaire showed a good ergonomic result for the RoboticScope whereas the use of a microscope showed unfavorable ergonomics with a risk of developing musculoskeletal symptoms.

Boehm F et al., 2021

Some limitations are listed which have already been addressed since the time of data collection for the study. The desire to connect a second Head-Mounted Display for the assisting surgeon (click here for more info about DualView), as well as an external monitor connection was implemented. Another point mentioned was the quite unnatural color of the surgical field. This issue was resolved shortly after the clinical testing. The colors now look more vivid and natural.


Despite the minor limitations at that time the study proves that the RoboticScope® is feasible for use and a promising device in reconstructive microvascular surgery of the head and neck.


Read the whole publication open to access here:



Boehm F, Schuler PJ, Riepl R, Schild L, Hoffmann TK, Greve J. Performance of microvascular anastomosis with a new robotic visualization system: proof of concept. J Robot Surg. 2021 Aug 19. doi: 10.1007/s11701-021-01294-5. Epub ahead of print. PMID: 34410583.