Pilot Study: RoboticScope (Robotic Microscope)-assisted Primary Cleft Palate Surgery

Abstract

Background: Conventional palatoplasty involves operating in a narrow oral cavity space with surgical loupe visualization. Today, some surgeons resort to surgical microscopes to improve visualization and obtain more precise muscle dissection. The RoboticScope is a head movement-controlled system that moves the robotic arm loaded with 3-dimensional visualization technology, allowing surgeons complete freedom to use their hands during surgery.

Methods: This was a retrospective pilot analysis of 8 pediatric patients, split into 2 cohorts of 4, comparing conventional palatoplasty to RoboticScope-assisted palatoplasty performed in 2023. Patient demographics collected included age, sex, and cleft palate classification (Veau I-IV). Variables measured included operative time, postoperative analgesia, oral intake, hospital stay, and complication rates. Ergonomic evaluations were performed through surgeons documenting their feedback on comfort and surgical efficiency, including dissection and repair.

Results: RoboticScope-assisted palatoplasty averaged 28 minutes longer than the conventional method. Postoperative analgesic needs also differed: 100% of the patients who underwent conventional palatoplasty required morphine, whereas only 50% of the RoboticScope patients required morphine. Seventy-five percent of the RoboticScope patients demonstrated good oral intake on day 1, and 50% of the patients were discharged 1 day earlier than the conventional group.

Conclusions: This study concludes that RoboticScope-assisted palatoplasty is safe and feasible, and is associated with fewer analgesic needs, better oral intake, and ergonomic benefits for surgeons than conventional palatoplasty. However, due to the limited nature of the study sample, future multicenter studies with a larger cohort group would be essential to validate these outcomes.

Fig. 1.

RoboticScope technology. A, Image of RoboticScope’s 6-axis robotic arm and HMD system. Image provided by BHS Technologies (GmbH, Innsbruck, Austria). Copyright 2024 BHS Technologies. B, Illustration showing the user interface of the RoboticScope, allowing intuitive control through head gestures. Image provided by BHS Technologies (GmbH, Innsbruck, Austria). Copyright 2024 BHS Technologies.

Fig. 2.

Bar chart illustrating the duration of operations in the RoboticScope and conventional palatoplasty cohorts.

Fig. 3.

Bar chart comparing postoperative analgesic requirements between the RoboticScope and conventional palatoplasty cohorts.

Fig. 4.

Pie chart depicting postoperative oral intake outcomes in the RoboticScope and conventional palatoplasty cohorts.

Fig. 5.

Visual representation of the intraoperative surgical field using the RoboticScope.

Fig. 6.

Illustration of intraoperative surgeon ergonomics during RoboticScope-assisted procedures.