Development and Evaluation of a Robotic Vessel Positioning System for Semi-Automatic Microvascular Anastomosis

This paper describes a novel tissue positioning system with an integrated suturing robot and demonstrates its ability to perform semi-automatic anastomoses of synthetic blood vessels. We began with a finite element analysis-based design consideration for achieving adequate grasping of blood vessels to demonstrate robust performance under expected clinical forces. We then conducted standardized positioning tests to measure the repeatability of the system and incorporated a high-resolution optical coherence tomography (OCT) fiber imaging sensor within the tip of the suturing tool to provide position feedback of the robot during a suturing task. Using the microvascular positioner and OCT sensor, the system performed semi-automatic suturing of synthetic 5 mm diameter blood vessels (N=4), and the suture quality was evaluated for consistency in spacing, bite depth, percent lumen reduction, and maximum suture strength. The system completed the task in an average time of 31.75 minutes. The samples had zero missed stitches, average spacing of 1.64 mm, an average bite depth of 2.14 mm, an average lumen reduction of 57.98%, and an average suture strength of 3.13 N.