Robot system good but not good enough

The da Vinci Surgical System (Intuitive Surgical) provides adequate dexterity for performing delicate intraocular manipulation, however, the kinematics of the robotic arms is insufficient for standard intraocular surgery, according to a study published in the January issue of Retina.

Dan Bourla and colleagues from the Jules Stein Eye Institute, University of California, Los Angeles, USA assessed the feasibility of performing intraocular robotic surgery with the da Vinci Surgical System. Using the modified robotic instrument, 25-gauge pars plana vitrectomy, intraocular foreign body removal and anterior capsulorhexis were performed on porcine eyes.

Control of the wrist-like movements allowed for a full range of movement and the dexterity of the robotic arms was excellent, with steady instrument motion. However, controlling the robotic arms was not as intuitive as moving the wrist. A high stable point of rotation induced motion-related stress at the site of instrument insertion. Visualization of the external operative field during intraocular procedures did require camera realignment and absent retro-illumination made anterior segment surgery difficult to perform.

According to the study, the da Vinci Surgical System is promising but it requires a few adjustments in order to make it suitable for performing intraocular surgery.