Robot-Assisted Doppler Optical Coherence Tomography for Intraoperative Evaluation of Microvascular Anastomoses

Intraoperative assessment of microvascular anastomoses is challenging because vessel patency and hemodynamics can change rapidly and are difficult to judge visually, especially for submillimeter vessels. Here, we present a robot-assisted Doppler optical coherence tomography (DOCT) system that performs autonomous wide-field, three-dimensional imaging of vascular anastomoses intraoperatively. The platform integrates machine-vision–guided vessel localization, adaptive path planning with probe pose adjustment, and continuous C-scan acquisition to generate stitched structural and hemodynamic maps over regions up to 2.2 × 3.5 × 20 (lateral × depth × longitudinal) mm. Quantitative phantom experiments validate Doppler flow sensing and image quality. In rat femoral and tail artery models, the system visualizes clinically relevant indicators—including patency, anastomotic narrowing, hematoma formation, and local flow disturbances—and enables longitudinal tracking of postanastomotic hemodynamic evolution. These results establish robot-assisted DOCT as a potential useful tool for automated, wide-field intraoperative microvascular assessment to support decision-making and training.