A Novel Microsurgical Robot: Preliminary Feasibility Test in Ophthalmic Field

PURPOSE: This study investigated the feasibility and potential advantage of using a new microsurgical teleoperated robot, Symani Surgical System, in the ophthalmology field. In particular, considering the extreme precision of the system and the dexterity of the instrument, possible use of the Symani Surgical System has been explored for suturing in corneal graft surgery. METHODS: Manual and robot-assisted suturing of partial corneal transplants was performed on the porcine eye model by an ophthalmologist with experience with the porcine model. Suturing execution time, suture placement, and tomographic parameters were analyzed to assess the regularity and distribution of corneal sutures for both manual and robotic treatment. RESULTS: The two robot-assisted procedures were properly completed on the porcine model, confirming the ease of use of the system and its capabilities, as well as the dexterity of the microinstruments. Manual and robotic treatments were found to be equivalent in terms of distance and angular precision of suture placement and corneal surface regularity (Gaussian anterior curvature). The robotic procedure required longer suturing execution times compared with the manual procedure. CONCLUSIONS: The technical and clinical feasibility of robot-assisted suturing of partial corneal graft using the Symani Surgical System has been confirmed for the first time, to our knowledge, using an ex vivo porcine model. Robotic suturing required longer time to complete but was equivalent to the manual procedure with regard to the imaging data collected. TRANSLATIONAL RELEVANCE: This study evaluated the use of the Symani Surgical System in the ophthalmology field. Future investigations could further identify the advantages offered by the stability, dexterity, and motion precision of the system for corneal surgeries, paving the way for clinical use in both adult and even more challenging pediatric therapy.