Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model
Background A subset of patients who undergo video‐assisted thoracoscopic sympathectomy for hyperhydrosis develop post‐procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an inte...
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| Veröffentlicht in: | The international journal of medical robotics + computer assisted surgery 2008-09, Vol.4 (3), p.258-262 |
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| container_title | The international journal of medical robotics + computer assisted surgery |
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| creator | Latif, M. J. Afthinos, J. N. Connery, C. P. Perin, N. Bhora, F. Y. Chwajol, M. Todd, G. J. Belsley, S. J. |
| description | Background
A subset of patients who undergo video‐assisted thoracoscopic sympathectomy for hyperhydrosis develop post‐procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an intercostal nerve graft using the da Vinci robot.
Methods
A robotic swine model was established using single‐lung ventilation and four ports. The pleura was incised and a representative segment of sympathetic chain was transected. A nearby intercostal nerve was harvested and sutured to the sympathetic chain using four interrupted 10‐0 nylon sutures on the epineurium.
Results
The intercostal nerve was an excellent size match and post‐procedure necropsy yielded successful anastomoses without apparent complications.
Conclusions
Robotic intercostal nerve grafting for reversal of thoracic sympathectomy is technically feasible. The robotic device allows the principles of neural microsurgery to be maintained and provides a minimally invasive option for reconstruction of the sympathetic chain. Copyright © 2008 John Wiley & Sons, Ltd. |
| doi_str_mv | 10.1002/rcs.205 |
| format | Article |
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A subset of patients who undergo video‐assisted thoracoscopic sympathectomy for hyperhydrosis develop post‐procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an intercostal nerve graft using the da Vinci robot.
Methods
A robotic swine model was established using single‐lung ventilation and four ports. The pleura was incised and a representative segment of sympathetic chain was transected. A nearby intercostal nerve was harvested and sutured to the sympathetic chain using four interrupted 10‐0 nylon sutures on the epineurium.
Results
The intercostal nerve was an excellent size match and post‐procedure necropsy yielded successful anastomoses without apparent complications.
Conclusions
Robotic intercostal nerve grafting for reversal of thoracic sympathectomy is technically feasible. The robotic device allows the principles of neural microsurgery to be maintained and provides a minimally invasive option for reconstruction of the sympathetic chain. Copyright © 2008 John Wiley & Sons, Ltd.</description><identifier>ISSN: 1478-5951</identifier><identifier>EISSN: 1478-596X</identifier><identifier>DOI: 10.1002/rcs.205</identifier><identifier>PMID: 18777515</identifier><language>eng</language><publisher>Chichester, UK: John Wiley & Sons, Ltd</publisher><subject>Animals ; compensatory sweating ; Disease Models, Animal ; Feasibility Studies ; Humans ; hyperhidrosis ; Hyperhidrosis - surgery ; Intercostal Nerves - transplantation ; nerve grafting ; robotic surgery ; Robotics - methods ; Surgery, Computer-Assisted - methods ; Swine ; Sympathectomy - instrumentation ; Sympathectomy - methods ; Thoracic Surgical Procedures - methods ; thoracic sympathectomy ; Treatment Outcome</subject><ispartof>The international journal of medical robotics + computer assisted surgery, 2008-09, Vol.4 (3), p.258-262</ispartof><rights>Copyright © 2008 John Wiley & Sons, Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3845-3e65606b56125d295a3bbff5a126ca6ced19cef68870e6e01bb19f3814419873</citedby><cites>FETCH-LOGICAL-c3845-3e65606b56125d295a3bbff5a126ca6ced19cef68870e6e01bb19f3814419873</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Frcs.205$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Frcs.205$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18777515$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Latif, M. J.</creatorcontrib><creatorcontrib>Afthinos, J. N.</creatorcontrib><creatorcontrib>Connery, C. P.</creatorcontrib><creatorcontrib>Perin, N.</creatorcontrib><creatorcontrib>Bhora, F. Y.</creatorcontrib><creatorcontrib>Chwajol, M.</creatorcontrib><creatorcontrib>Todd, G. J.</creatorcontrib><creatorcontrib>Belsley, S. J.</creatorcontrib><title>Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model</title><title>The international journal of medical robotics + computer assisted surgery</title><addtitle>Int. J. Med. Robotics Comput. Assist. Surg</addtitle><description>Background
A subset of patients who undergo video‐assisted thoracoscopic sympathectomy for hyperhydrosis develop post‐procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an intercostal nerve graft using the da Vinci robot.
Methods
A robotic swine model was established using single‐lung ventilation and four ports. The pleura was incised and a representative segment of sympathetic chain was transected. A nearby intercostal nerve was harvested and sutured to the sympathetic chain using four interrupted 10‐0 nylon sutures on the epineurium.
Results
The intercostal nerve was an excellent size match and post‐procedure necropsy yielded successful anastomoses without apparent complications.
Conclusions
Robotic intercostal nerve grafting for reversal of thoracic sympathectomy is technically feasible. The robotic device allows the principles of neural microsurgery to be maintained and provides a minimally invasive option for reconstruction of the sympathetic chain. Copyright © 2008 John Wiley & Sons, Ltd.</description><subject>Animals</subject><subject>compensatory sweating</subject><subject>Disease Models, Animal</subject><subject>Feasibility Studies</subject><subject>Humans</subject><subject>hyperhidrosis</subject><subject>Hyperhidrosis - surgery</subject><subject>Intercostal Nerves - transplantation</subject><subject>nerve grafting</subject><subject>robotic surgery</subject><subject>Robotics - methods</subject><subject>Surgery, Computer-Assisted - methods</subject><subject>Swine</subject><subject>Sympathectomy - instrumentation</subject><subject>Sympathectomy - methods</subject><subject>Thoracic Surgical Procedures - methods</subject><subject>thoracic sympathectomy</subject><subject>Treatment Outcome</subject><issn>1478-5951</issn><issn>1478-596X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqF0F1PFDEUBuDGSORDwz8gvdILM9BOP6bjndngqgGNQJS7ptM9ZQsz26XtAvPvrZkNXhmvepI-503Oi9AhJceUkPok2nRcE_EC7VHeqEq08vrl8yzoLtpP6ZYQLrjkr9AuVU3TCCr20PIidCF7i_0qQ7QhZdPjFcQHwDfRuIxdiDjCA8RUPoLDeRmisWUhjcPa5CXYHIbxAza4N_EGsFn5oUgHJvnO9z6PeAgL6F-jHWf6BG-27wG6-nR6NftcnX2ff5l9PKssU1xUDKSQRHZC0los6lYY1nXOCUNraY20sKCtBSeVaghIILTraOuYopzTVjXsAL2dYtcx3G8gZT34ZKHvzQrCJmnZCqaYkv-FTBClOK8LfDdBG0NKEZxex3JiHDUl-k_5upSvS_lFHm0jN90Ai79u23YB7yfw6HsY_5WjL2aXU1w1aZ8yPD1rE--0bFgj9K9vc_3j6zX9eT6_1DX7DbD5ncI</recordid><startdate>200809</startdate><enddate>200809</enddate><creator>Latif, M. J.</creator><creator>Afthinos, J. N.</creator><creator>Connery, C. P.</creator><creator>Perin, N.</creator><creator>Bhora, F. Y.</creator><creator>Chwajol, M.</creator><creator>Todd, G. J.</creator><creator>Belsley, S. J.</creator><general>John Wiley & Sons, Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7SC</scope><scope>7SP</scope><scope>7TB</scope><scope>8FD</scope><scope>F28</scope><scope>FR3</scope><scope>JQ2</scope><scope>L7M</scope><scope>L~C</scope><scope>L~D</scope><scope>7X8</scope></search><sort><creationdate>200809</creationdate><title>Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model</title><author>Latif, M. J. ; Afthinos, J. N. ; Connery, C. P. ; Perin, N. ; Bhora, F. Y. ; Chwajol, M. ; Todd, G. J. ; Belsley, S. J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3845-3e65606b56125d295a3bbff5a126ca6ced19cef68870e6e01bb19f3814419873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Animals</topic><topic>compensatory sweating</topic><topic>Disease Models, Animal</topic><topic>Feasibility Studies</topic><topic>Humans</topic><topic>hyperhidrosis</topic><topic>Hyperhidrosis - surgery</topic><topic>Intercostal Nerves - transplantation</topic><topic>nerve grafting</topic><topic>robotic surgery</topic><topic>Robotics - methods</topic><topic>Surgery, Computer-Assisted - methods</topic><topic>Swine</topic><topic>Sympathectomy - instrumentation</topic><topic>Sympathectomy - methods</topic><topic>Thoracic Surgical Procedures - methods</topic><topic>thoracic sympathectomy</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Latif, M. J.</creatorcontrib><creatorcontrib>Afthinos, J. N.</creatorcontrib><creatorcontrib>Connery, C. P.</creatorcontrib><creatorcontrib>Perin, N.</creatorcontrib><creatorcontrib>Bhora, F. Y.</creatorcontrib><creatorcontrib>Chwajol, M.</creatorcontrib><creatorcontrib>Todd, G. J.</creatorcontrib><creatorcontrib>Belsley, S. J.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Computer and Information Systems Abstracts</collection><collection>Electronics & Communications Abstracts</collection><collection>Mechanical & Transportation Engineering Abstracts</collection><collection>Technology Research Database</collection><collection>ANTE: Abstracts in New Technology & Engineering</collection><collection>Engineering Research Database</collection><collection>ProQuest Computer Science Collection</collection><collection>Advanced Technologies Database with Aerospace</collection><collection>Computer and Information Systems Abstracts Academic</collection><collection>Computer and Information Systems Abstracts Professional</collection><collection>MEDLINE - Academic</collection><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Latif, M. J.</au><au>Afthinos, J. N.</au><au>Connery, C. P.</au><au>Perin, N.</au><au>Bhora, F. Y.</au><au>Chwajol, M.</au><au>Todd, G. J.</au><au>Belsley, S. J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model</atitle><jtitle>The international journal of medical robotics + computer assisted surgery</jtitle><addtitle>Int. J. Med. Robotics Comput. Assist. Surg</addtitle><date>2008-09</date><risdate>2008</risdate><volume>4</volume><issue>3</issue><spage>258</spage><epage>262</epage><pages>258-262</pages><issn>1478-5951</issn><eissn>1478-596X</eissn><abstract>Background
A subset of patients who undergo video‐assisted thoracoscopic sympathectomy for hyperhydrosis develop post‐procedure compensatory sweating that is perceived as more debilitating than their initial complaints. We propose a novel treatment to reverse sympathectomy by implantation of an intercostal nerve graft using the da Vinci robot.
Methods
A robotic swine model was established using single‐lung ventilation and four ports. The pleura was incised and a representative segment of sympathetic chain was transected. A nearby intercostal nerve was harvested and sutured to the sympathetic chain using four interrupted 10‐0 nylon sutures on the epineurium.
Results
The intercostal nerve was an excellent size match and post‐procedure necropsy yielded successful anastomoses without apparent complications.
Conclusions
Robotic intercostal nerve grafting for reversal of thoracic sympathectomy is technically feasible. The robotic device allows the principles of neural microsurgery to be maintained and provides a minimally invasive option for reconstruction of the sympathetic chain. Copyright © 2008 John Wiley & Sons, Ltd.</abstract><cop>Chichester, UK</cop><pub>John Wiley & Sons, Ltd</pub><pmid>18777515</pmid><doi>10.1002/rcs.205</doi><tpages>5</tpages></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Animals compensatory sweating Disease Models, Animal Feasibility Studies Humans hyperhidrosis Hyperhidrosis - surgery Intercostal Nerves - transplantation nerve grafting robotic surgery Robotics - methods Surgery, Computer-Assisted - methods Swine Sympathectomy - instrumentation Sympathectomy - methods Thoracic Surgical Procedures - methods thoracic sympathectomy Treatment Outcome |
| title | Robotic intercostal nerve graft for reversal of thoracic sympathectomy: a large animal feasibility model |
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