Robotic Vitreoretinal Surgery

Abstract

Purpose:: To test the feasibility of performing vitreoretinal surgery with a commercially available surgical robot.

Methods:: Using a Da Vinci Surgical Robot (Intuitive Surgical, Inc., Sunnyvale, CA), ocular vitreo-retinal surgery was performed using a 3 port 25-gauge system as well as combined 2 port 25-gauge and 1 port 20-gauge pars plana vitrectomy in a porcine model. The experiments were done on harvested eyes placed in an anatomical position using a foam head on a standard operating room table. A video scope with an AVI wide angle viewing system was employed with custom-made instruments placed and manipulated in the eye with the robotic arms. The surgeon performed the actual procedures while positioned at a robotic system console that was located across the operating room. Core vitrectomies, rupture globe repair and intraocular foreign body removal were performed.

Results:: Vitrectomy was successfully performed using the Da Vinci Surgical Robot. The robotic system provided good visualization as well as controlled placement of the 25-gauge trocars and intraocular instrument manipulation.

Conclusions:: Robotic vitreoretinal surgery is technically feasible in the porcine model and warrants consideration for future development of robotic systems that are designed for ophthalmic microsurgery.

Keywords: vitreoretinal surgery • trauma • sclera