Evidence map›Paper›PMID 37546233›Full record

ArticleJPRAS open2023

Benefits of robotic-assisted lymphatic microsurgery in deep anatomical planes.

Andrea Weinzierl, Carlotta Barbon, Epameinondas Gousopoulos, Donata von Reibnitz, Pietro Giovanoli, Lisanne Grünherz, Nicole Lindenblatt

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JPRAS open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
36citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

36 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
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  6. Review
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  10. The first total robotic-assisted lymphovenous anastomosis: prospects for innovation and future development.International journal of computer assisted radiology and surgery · 2026
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  11. Advancing Robotic-assisted Microsurgery for Access to Deep Anatomical Structures.Plastic and reconstructive surgery. Global open · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Andrea WeinzierlDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland.
Carlotta BarbonDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland.
Epameinondas GousopoulosDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland.
Donata von ReibnitzDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland.
Pietro GiovanoliDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland.
Lisanne GrünherzDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland.
Nicole LindenblattDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Micro- and supermicrosurgeries have become standard techniques for lymphatic reconstruction. As increasingly smaller vessels are being targeted, robotic-assisted surgery has emerged as a new approach to push reconstructive limits owing to its ability of motion scaling and providing better accessibility of deep anatomical regions. The precision of the robot is achieved at the expense of operating speed among other variables; therefore, the surgeon must weigh the enhanced dexterity against the additional operating time and cost required for the robotic surgical system itself to ensure optimal resource utilization. Here we present a case series of 8 patients who underwent robot-assisted lymphatic microsurgery for omental flap transfer to the axilla and lympho-venous anastomosis. The Symani® Surgical System was used with a conventional microscope or 3D exoscope. The use of 3D exoscope provided clear benefits in terms of surgeon positioning. Moreover, access to the recipient vessels near the thoracic wall was significantly improved with the robotic setup. In addition, suture precision was excellent, resulting in patent anastomoses. Operating time for anastomosis was comparable to that for manual anastomosis and demonstrated a steep learning curve. The benefits of robotic systems in operating fields with good exposure require further evaluation. However, owing to longer instruments, additional stability, dexterity, and motion precision, robotic systems offer a marked advantage for operating in deep anatomical planes and on small structures. A potentially new field for the implementation of robotic surgery is central lymphatic reconstruction. Progress in terms of operating time and cost is crucial, and future research should validate the effectiveness of robotic-assisted surgery in larger clinical studies.

Indexed as

Central lymphatic surgeryLymphatic surgeryMicrosurgeryRobotic-assisted microsurgeryRobotic microsurgery

Identifiers

PMID37546233
PMCPMC10403710

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Registered trials

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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.