Use of the Symani® microscopic surgical robot in hand surgery and operating room setup.

Robotic surgery has introduced significant innovations in hand microsurgery, enabling complex procedures such as nerve sutures and arterial and venous anastomoses to be performed with greater precision and control. The Symani® Surgical System represents a promising advancement over conventional techniques by offering enhanced dexterity, tremor elimination, and motion scaling to improve microsurgical outcomes. While most studies in the literature focus on clinical comparisons between traditional and robotic approaches, our work aims to explore the practical aspects of integrating the Symani® into hand surgery. Specifically, we describe the structured training pathway for both surgeons and nursing staff, along with a detailed setup of the operating room, including optimal team positioning and coordination. Our early experience suggests that, following a dedicated learning curve, the Symani® system can be successfully implemented in microsurgical clinical practice. Proper team training and operating room organization are essential to maximize the system's benefits in terms of safety, efficiency, and surgical precision.