Robot-assisted airway support: a simulated case

Abstract

Recent advances in telemedicine and robotically assisted telesurgery may offer advanced surgical care for the geographically remote patient. Similar advances in tele-anesthesia will be necessary to optimize perioperative care for these patients. Although many preliminary investigations into tele-anesthesia are underway, none involves remote performance of anesthesia-related procedures. Here we describe simulated robotically assisted fiberoptic intubations using an airway simulation mannequin. Both oral and nasal approaches to fiberoptic intubation were successful, but presented unique opportunities and challenges inherent to the robot's design. Robotically assisted airway management is feasible using multipurpose surgical robotic systems.

Figure 1

Schematic depicting the arrangement of the DaVinci Surgical System type S (DVS), bronchoscope, and airway mannequin.

Figure 2

Schematic depicting the arrangement of the DaVinci Surgical System type S (DVS), bronchoscope, and airway mannequin.

Figure 3

The handle of the bronchoscope was positioned into a robotic arm. Two other robotic arms were fitted with graspers and used to control the flexion and extension of the bronchoscope tip.

Figure 4

Image from the DaVinci workstation during the robotically assisted fiberoptic intubation. The robot operator can simultaneously visualize video output from both the bronchoscope and the robot’s main camera without turning attention away from the workstation.