ArticlePlastic and reconstructive surgery. Global open2022
Early Experience Using a New Robotic Microsurgical System for Lymphatic Surgery.
Article in Plastic and reconstructive surgery. Global open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 98 citations in OpenAlex.
- Dedicated Robotic-Assisted Microsurgery Platforms in Plastic and Reconstructive Surgery: A Systematic Review.Microsurgery · 2026Pooled it
- Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review.Sensors (Basel, Switzerland) · 2025Pooled it
- Systematic Review of Robotic-Assisted Peripheral and Central Lymphatic Surgery.Journal of surgical oncology · 2025Pooled it
- The emerging role of robotics in plastic and reconstructive surgery: a systematic review and meta-analysis.Journal of robotic surgery · 2024Pooled it
- Microsurgical robotic system enables the performance of microvascular anastomoses: a randomized in vivo preclinical trial.Scientific reports · 2023Trial
- Global research trends and thematic evolution in robotic microsurgery and supermicrosurgery: a bibliometric and visualisation study.Journal of robotic surgery · 2026Review
- Entirely Robotic-assisted Microsurgical Anastomoses in Autologous Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2026Article
- Facial Nerve Repair Using a Microsurgical Robot System: A Preclinical Study Using a Rat Model.Plastic and reconstructive surgery. Global open · 2026Article
- The Current Landscape of Robotics in Lymphatic Supermicrosurgery: A Systematic Review.Archives of plastic surgery · 2026Article
- Enabling non-microsurgeons to perform supermicrovascular anastomosis using a robotic assistant: A preclinical study.Scientific reports · 2026Article
- Microvascular Anastomoses and Beyond: Exploring the Role of Robotic Systems in Microneurosurgery.Journal of robotic surgery · 2026Review
- Comparison of Robotic-assisted and Conventional Deep Inferior Epigastric Perforator Flaps: A Retrospective Cohort Study.Plastic and reconstructive surgery. Global open · 2026Article
- The first total robotic-assisted lymphovenous anastomosis: prospects for innovation and future development.International journal of computer assisted radiology and surgery · 2026Article
- Advancements in robotic assisted microsurgery: Exploring the MUSA robot in reconstructive microsurgical and supermicrosurgical procedures.JPRAS open · 2026Review
- [Research progress of lymphaticovenous anastomosis in treatment of secondary lymphedema].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- Robot-Assisted Surgical Technology in Plastic Surgery: Evolution, Clinical Applications, and Future Perspectives.Aesthetic plastic surgery · 2026Review
- Brain Drain for Brain Gain: Potential Applications of Robotic-assisted Lymphatic Microsurgery in the Management of Neurological Disorders.Plastic and reconstructive surgery. Global open · 2025Article
- Can robotic assistance mitigate the negative impact of sleep deprivation on surgical performance in microsurgical tasks?JPRAS open · 2025Article
- Further Validating the Robotic Microsurgery Platform through Preclinical Studies on Rat Femoral Artery and Vein.Journal of reconstructive microsurgery · 2025Article
- Robotic-Assisted Lymphatic Supermicrosurgery for Breast Lymphedema-A Case Report and Literature Review.Annals of plastic surgery · 2025Review
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Robotic microsurgery has emerged as a new technology with potential benefits for reconstructive surgery. We report the first-in-human use of the Symani surgical system to perform lympho-venous and arterial anastomosis for lymphatic reconstruction. In five patients, 10 robot-assisted anastomoses were performed. Next to lympho-venous anastomoses, two patients received a free vascularized lymph node transfer. Motion scaling was set to 10×. Visualization was either achieved with a 3D system or an optical microscope. All anastomoses were patent as confirmed by ICG. Despite a longer time to perform the first anastomoses with the robot, we observed a decline in duration of anastomosis. Among the advantages of the system were a high accuracy in placing the stitches even in very small and fragile vessels or when performing anastomoses with size mismatches. The challenges encountered included the lack of a touch sensation and the necessity to develop a "see-feel." This could be achieved surprisingly well because the force necessary to close dilator and needle holder via the manipulators was perceived as comparable to using conventional micro instruments. Our data confirm feasibility and safety of the robotic system to perform lymphatic surgery. Larger patient cohorts and inclusion of surgeons at different training levels will be necessary to investigate the true potential of robotics in microsurgery. In addition, robot-assisted surgery shows a promising potential in opening up new frontiers in reconstructive microsurgery (eg, the reliable performance of anastomoses on even smaller blood and lymphatic vessels or on structures deeper within the body cavities-eg, the thoracic duct).
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.