Discussion
thrombosis, biceps femoris muscle, quadriceps femoris muscle, ischemia, venous and arterial anastomoses
THROMBOSIS, ISCHEMIA
This in vivo preclinical study presents for the first time data that demonstrate the feasibility and accuracy of using the Symani Surgical System in arterial and venous microvascular anastomoses based on patency, time for anastomosis execution, and histology of operated vessels.In this study, there were no blood vessel diameter differences in the vein and artery studies nor in robotic and manual procedures. This demonstrates that patency, histological and execution time results were not influenced by vessel-size differences, which we consider essential to delineate the conclusions from our preclinical study.Patency results and Chi-squared tests confirmed that the robotic and manual techniques for venous and arterial anastomoses were equivalent in terms of patency after anastomosis, as had already been observed with the use of Musa, the other microsurgery robot on the marketRegarding execution times, our results were similar to those using the Musa robot, since the time to perform the anastomosis was longer with the robotHistological analysis showed less total average host reaction score at the anastomotic site in robotic anastomoses. The total average score was lower in robotic procedures for both vein and artery studies. This may be due to the ability of robotic systems to improve surgery by extending human capabilities by reducing surgeons' movements and scaling micro-movements, and eliminating physical tremorThere were no clinical signs of thrombosis or ischemia during the survival period. Even in animals in which the femoral vessel anastomosis were not patent, hindlimb blood flow was not totally compromised since three collateral routes through intramuscular networks in the quadriceps femoris muscle, biceps femoris muscle and the medial thigh muscles including the medial hamstring muscles and adductor muscles remained intact as previously described in literature