Robotic-assisted laparoscopic microsurgical tubal anastomosis: a human pilot study

OBJECTIVE: To evaluate the feasibility and safety of a robotic device to perform a laparoscopic tubal anastomosis. DESIGN: Prospective pilot study. SETTING: Tertiary care medical center. PATIENT(s): Ten patients with previous tubal ligations underwent laparoscopic tubal ligation reversal using a robotic suturing device. INTERVENTION(s): Tubal surgery was performed with a robotic system. A two-layered closure was used for all tubes. Four stitches of 8-0 polygalactin sutures were used for each layer. MAIN OUTCOME MEASURE(s): Tubal patency; secondary measures were pregnancy rates, complications, and operative time. RESULT(s): The procedure was completed successfully in all 10 patients. No patient required conversion to an open procedure. The mean time (+/-SD) required to complete the anastomosis of both tubes was 159 +/- 33.8 minutes. Chromotubation at the end of the procedure showed patency in all tubes anastomosed. A postoperative hysterosalpingogram 6 weeks after surgery demonstrated patency in 17 of the 19 (89%) tubes anastomosed. There have been five pregnancies so far. There were no complications. CONCLUSION(s): Robotic technology can be used safely to create laparoscopic microsurgical anastomoses with adequate patency rates. Robotic technology has the potential to make laparoscopic microsuturing easier.