The First Microsurgery-assisting Robot Equipped With an Automatic Instrument Exchange System and a Miniature Tool Kit

Abstract

Microsurgery requires high precision, stability, and effective teamwork. However, current robotic-assisted surgery faces challenges such as inefficient instrument exchange and dependence on surgical assistants, contributing to prolonged operative times and increased costs. To address these issues and enhance surgical efficiency and surgeon autonomy, we developed a microsurgery-assisting robot equipped with an automated instrument exchange system and a specialized micro tool kit. The robot was tested using chicken-wing arteries and rat vessels with diameters ranging from 0.35 to 0.8 mm. Evaluation parameters included anastomosis time, frequency of instrument exchanges, and vascular patency rates. The automated system completed instrument exchanges accurately within approximately 9 seconds, maintaining a smooth workflow while significantly reducing reliance on assistants. In the rat model, a vascular patency rate of 100% was achieved. Although anastomosis times were slightly longer compared with manual operations performed by skilled surgeons, our system is anticipated to improve accuracy in complex microsurgical procedures involving extremely fine vessels. Conventional microsurgery-assisting robots have primarily focused on performing vascular anastomosis alone; however, our newly developed robot with an automated instrument exchange mechanism effectively facilitates a broader range of tasks, including vessel dissection, trimming, vascular anastomosis, and postoperative patency assessments.