Article review

Use of RoboticScope® to perform lymphovenous anastomosis

In November, we wrote a blog post about a super microsurgery, performed in Lucerne, Switzerland by Mario Scaglioni. This week PD Dr. Mario Scaglioni et al. have also published an article in Microsurgery issue (John Wiley and Sons) about the usage of RoboticScope® in super microsurgical lymphovenous anastomosis.

 

Lymphovenous anastomosis is a microsurgical procedure where the surgeon connects a lymph vessel in the affected limb to a nearby vein to bypass the damaged area and restore the flow of lymph fluid back to the venous system. See the pictures below:

As Scaglioni et al. are stating in this article, over the course of the last years big steps forward were made when it comes to the development of microsurgical tools and supporting the work of the surgeon. However, the authors state, that most solutions available at the moment constitute a compromise between efficacy and practicality.

 

Generally, the development of microsurgical microscopes has been focusing on offering the best possible view of the surgical field under all circumstances, including 3D vision combined with the highest possible resolution. Also, the ergonomics of the microscope are becoming increasing important in the light of long and challenging microsurgical operations to ensure reliable and reproducible good outcomes. (Scaglioni et al.)

 

This is where the RoboticScope® comes into play. What makes RoboticScope® so special, is the separation of the eyepieces from the objective: in comparison to a conventional microscope, where the surgeon first has to manually place the microscope over the surgical field and then stay positioned in immediate proximity to the microscope to be able to view the OR-field, with RoboticScope® the surgeon is able to take an ergonomic operating position and adjust the microscope totally hands-free.

 

This revolutionary instrument combines a very high-resolution digital image with game changing ergonomics. The operating field remains always in view and no manual adjustments or change of hands are needed.

Scaglioni et al. 2021

The tutors state: “All these features provide a much more ergonomic posture and intuitive scope control avoiding the surgeon being immobilized in the same position for any longer period of the time. All the functions and the scope menu and settings from zooming to turning the camera head are controlled by a foot clutch and the head movements of the surgeon.”

 

As an empirical source Scaglioni et al. performed multiple lymphovenous anastomosis in the arm of a 77-year-old women with breast cancer related lymphedema refractory. During the procedure they reached a magnification up to ×34.4 with no decrease in image resolution.

 

According to the authors some further evidence is still needed to confirm the efficacy of the RoboticScope®, but it is perceivable that this new technology could be a significant advantage in the microsurgical and supermicrosurgical setting, allowing the surgeons to work in a more accurate, more flexible, faster and safer manner.

 

 

Article about RoboticScope® written by Mario F. Scaglioni, Matteo Meroni, Elmar Fritsche, Thomas Linder and Gunesh Rajan, published in Microsurgery issue from John Wiley and Sons 01/2021. Read the full article here!

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