A comparison of robotic and manual surgery for internal limiting membrane peeling
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A comparison of robotic and manual surgery for internal limiting membrane peeling David A L Maberley 1 Marc D de Smet 2,4
&
Maarten Beelen 2 & Jorrit Smit 2 & Thijs Meenink 2 & Gerrit Naus 2 & Clemens Wagner 3 &
Received: 15 October 2019 / Revised: 17 January 2020 / Accepted: 27 January 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To compare the Preceyes Surgical Robotic System (Eindhoven, Netherlands) to manual internal limiting membrane (ILM) peeling using the Eyesi surgical simulator (VRmagic, Mannheim, Germany) as the operative platform. Methods A comparative study was carried out with surgeons initially performing ILM peeling manually and then with the robot. Twenty-three vitreoretinal surgeons agreed to participate and all consented to the use of their surgical data from the Eyesi surgical simulator. Surgeons were given a 5-min demonstration of the devices and were allowed to practice for 10 min before attempting the membrane peel. Initially, the peel was performed manually and afterwards, this was repeated using the robot-controlled forceps. Surgical simulator outcome measures were compared between approaches. Results The average time required for the procedure was 5 min for the manual approach and 9 min with the robot (paired t test, p = 0.002). Intraocular instrument movement was reduced by half with the robot. On average 344 mm was required to complete the ILM peeling with the robot compared with 600 mm using the manual approach (paired t test, p = 0.002). There were fewer macular retinal hemorrhages with the robot: 53 with manual surgery, 32 with the robot (Mann-Whitney U test, p = 0.035). Retinal injuries were eliminated with the robot. Conclusions Intraocular robotic surgery is still in its infancy and validation work is needed to understand the potential benefits and limitations of emerging technologies. Safety enhancements over current techniques may be possible and could lead to the broader adoption of robotic intraocular surgery in the future. Keywords Vitreoretinal surgery . Robotic surgery . Internal limiting membrane peeling . Comparative trial
Meeting presentation 1. Oral presentation at FLORetina meeting – Florence, Italy (June 7, 2019) 2. ePoster theatre presentation at American Academy of Ophthalmology 2019 – San Francisco (October 13, 2019) * David A L Maberley [email protected]
Clemens Wagner [email protected] Marc D de Smet [email protected]
Maarten Beelen [email protected] Jorrit Smit [email protected] Thijs Meenink [email protected] Gerrit Naus [email protected]
1
Department of Ophthalmology and Visual Sciences, The University of British Columbia, Vancouver, British Columbia, Canada
2
Preceyes B.V., Eindhoven, The Netherlands
3
VRmagic Holding AG, Mannheim, Germany
4
MicroInvasive Ocular Surgery Center (MIOS sa), Lausanne, Switzerland
Graefes Arch Clin Exp Ophthalmol
Abbreviations ILM Internal limiting membrane OCT Optical coherence tomography
Introduction Robotic surgery ha
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