Table 3.
Preclinical and clinical studies relating to the use of robotics in nerve surgery.
| Reference | Year | Study design | Operations performed | Outcomes reported |
|---|---|---|---|---|
| Preclinical studies | ||||
| Latif et al. (34) | 2008 | Animal model | Intercostal nerve grafting for reversal of thoracic sympathectomy (N = 1) | Successful anastomosis with no apparent complications |
| Nectoux et al. (35) | 2009 | Animal and human tissue samples | Extrafascicular neurolysis, donor nerve dissection and subsequent repair of peripheral nerve (N not reported) | The robot removed physiological tremor There was some technical difficulty with the choice and manipulation of the three-dimensional stereoscopic vision enabled a better view and safe and accurate repair of peripheral nerve lesions |
| Mantovani et al. (36) | 2011 | Human cadaver | Supraclavicular brachial plexus exploration and nerve graft anastomosis and reconstruction (N = 2) | The robot allowed microsurgery to be performed in a very small space with telemanipulation and minimally invasive techniques |
| Garcia et al. (37) | 2012 | Human cadaver | Sural nerve graft and neurotisation using the accessory nerve (N = 3) | The goals of the operation were achieved without conversion to open surgery. There were no complications |
| de Melo et al. (38) | 2013 | Human cadaver | Microsurgical nerve transfer of the branches of the axillary nerve onto the nerve of the long head of the triceps brachii (N = 1) | Dissection and transfer achieved successfully |
| Facca et al. (39) | 2014 | Human cadaver | Sural nerge graft between C5 root or spinal nerve, and the musculocutaneous nerve (N = 8) | Endoscopic treatment of supraclavicular nerve palsy is feasible, however, both sural nerve grafts and C5-6 avulsions were converted to open |
| Porto de Melo et al. (40) | 2014 | Animal model | Phrenic nerve harvest and application in brachial plexus surgery (N = 1) | Successful nerve harvest |
| Miyamoto et al. (41) | 2016 | Animal model | Intercostal nerve harvest for brachial plexus reconstruction (N = 3) | Physiological tremor was eliminated and there were no major complications |
| Clinical studies | ||||
| Latif et al. (42) | 2011 | Case study | Intercostal nerve graft harvesting and grafting into sympathetic chain using tension free nerve anastomoses (N = 1) | Successful operation, patient discharged one day postoperatively and no sign of Horner’s syndrome on short term follow-up |
| Coveliers et al. (43) | 2013 | Case cohort, retrospective | Selective postganglionic thoracic sympathectomy for patients with palmar or axillary hyperhidrosis (N = 110 operations in 55 patients) | Of the 55 patients, 53 (96%) had sustained relief of their hyperhidrosis at a median follow-up of 24 months (range, 3 to 36 months), and compensatory sweating was seen in four patients (7.2%) |
| Naito et al. (44) | 2012 | Case cohort | The Oberlin procedure of nerve transfer for restoration of elbow flexion (N = 4) | At 12 months’ mean follow-up, all patients had recovered to useful elbow flexion, with no sensory/motor deficit in the ulnar nerve territory |
| Berner (45) (book chapter) | 2013 | Case series | Repair of brachial plexus injury (N = 12) | Considering the microsurgical gesture, all nerve repairs were achieved under excellent conditions Need to convert to open surgery in nine cases |
| Tigan et al. (46) | 2014 | Case cohort | Nerve grafting after excision of benign peripheral nerve tumors (N = 7) | In postoperative surveys, neuropathic pain halved from 6/10 to 3/10 postop, with no worsening of sensory deficits |
The number of procedures carried out in each study is documented and represented as N number.