Robotic intercostal nerve harvest: a feasibility study in a pig model

J Neurosurg. 2016 Jan;124(1):264-8. doi: 10.3171/2015.1.JNS14603. Epub 2015 Jul 24.

Abstract

The aim of this study was to report the feasibility of robotic intercostal nerve harvest in a pig model. A surgical robot, the da Vinci Model S system, was installed after the creation of 3 ports in the pig's left chest. The posterior edges of the fourth, fifth, and sixth intercostal nerves were isolated at the level of the anterior axillary line. The anterior edges of the nerves were transected at the rib cartilage zone. Three intercostal nerve harvesting procedures, requiring an average of 33 minutes, were successfully performed in 3 pigs without major complications. The advantages of robotic microsurgery for intercostal nerve harvest include elimination of physiological tremor, free movement of joint-equipped robotic arms, and amplification of the surgeon's hand motion by as much as 5 times. Robot-assisted neurolysis may be clinically useful for intercostal nerve harvest for brachial plexus reconstruction.

Keywords: brachial plexus; da Vinci robot; intercostal nerve; robotic microsurgery; surgical technique; telemicrosurgery.

MeSH terms

  • Animals
  • Brachial Plexus / surgery
  • Feasibility Studies
  • Intercostal Nerves / surgery*
  • Microsurgery / instrumentation
  • Microsurgery / methods
  • Nerve Transfer / methods*
  • Neurosurgical Procedures / instrumentation*
  • Neurosurgical Procedures / methods*
  • Plastic Surgery Procedures
  • Robotic Surgical Procedures*
  • Sus scrofa
  • Swine / physiology*
  • Thorax