Table 2.
Characterization of all studies of robotic-assisted microsurgery with greater than 10 patients.
| Author (Year) | Type of Study | Level of Evidence | Population | Cohort size | Control group | Mean age (%female) | Inclusion Criteria | Exclusion Criteria | Mean Follow-Up | Outcomes Measured | Results | Comments |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| van Mulken et al., 2020 | Prospective | II | Women with breast-cancer related lymphadema Maastricht, Netherlands |
20 Robot, n = 8 |
Manual, n = 12 | 60 years (100%) | Women w/ breast cancer | Not reported | 3 months | Use of compressive garment Manual lymph drainage Mean Lymph-ICF score Mean Upper Extremity Lymphadema (UEL) index of the affected arm |
Daily compressive garment: Robot: 1/8 (12.5%) Manual: 2/12 (16.7%) No sig. differences in mean Lymph-ICF score at 1m or 3m No sig. differences in UEL index at 1m or 3m |
Short f/u period Small sample size Neither surgeon nor patient was blinded to group assignment |
| Boyd et al., 2006 | Case series | IV | Patients with need for TRAM, SGA, SIEA, and SGAP flaps Weston, Florida |
20 (22 flaps) | N/A | 53.7 | Patients with need for TRAM, SGA, SIEA, and SGAP flaps | Not reported | Not reported | Mean time for robotic harvest Mean ICU time Mean chest tube time Mean admission Pedicle and flap properties |
Mean robot harvest time: 113 min Mean ICU time: 2.95 days Mean chest tube time: 2.10 days Mean admission: 7.20 days Complications: Hematomas (n = 6), flap loss (n = 2), positional neuropraxia (n = 2), pneumothroax (n = 1), MRSA pneumonia (n = 1), Mild fat necrosis (n = 1) |
High complication rate No long-term outcomes Expense of robot and difficulty training |
| McCullough et al., 2018 | Retrospective | IV | Men w/ sympathetic hypogonadism undergoing robot-assisted microscopic varicocelectomy (RAMV) Albany, NY |
140 | N/A | 34.5 years (0%) | Normal karyotype and negative microdeletion studies >1 year of infertility Varicocoeles |
No varicocele | Not reported | Operative time Testicular volume, median testosterone, sperm concentration, motility, and WHO morphology Complications Need for pain medications >24h |
No sig. difference in operative time for RAMV vs. traditional Median T and free T increased by 44.3% (p < 0.001) Sperm concentration increased by 37.3% (p<0.03) No difference in sperm motility or WHO morphology 9/258 (3.5%) had complications 37.3% used pain medications >24 h |
High failure rate/persistence rate: 9.7% Comparison to historical controls |
| Lai et al., 2019 | Retrospective | IV | H/N Cancer Patients Taichung, China |
15 17 robot-assisted microanastamoses |
25 microanastamoses with standard operating microscope/hand sewing technique | 52.93 | Patients with H/N SCC | Not reported | 115 months | Operating time Number of suture stitches needed for vessel anastomosis Vessel-related complications Flap survival Outcomes |
Operating time sig. longer for robot No intraoperative complications All flaps survived Recipient blood vessel in robot group non-sig. smaller than traditional Donor blood vessel diameter in robot group sig. smaller than traditional |
Small sample size |