Evidence map›Paper›PMID 41776112›Full record

ArticleInternational journal of computer assisted radiology and surgery2026

The first total robotic-assisted lymphovenous anastomosis: prospects for innovation and future development.

Carlotta Imholz, Carmen E Zurfluh, Jennifer A Watson, Nicole Lindenblatt

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Article in International journal of computer assisted radiology and surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

4 authors.

Carlotta ImholzDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Carmen E ZurfluhDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Jennifer A WatsonDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland.
Nicole LindenblattDepartment of Plastic Surgery and Hand Surgery, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland. nicole.lindenblatt@usz.ch.ORCID http://orcid.org/0000-0003-0293-1004

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeLymphovenous anastomosis is a well-established treatment method for peripheral lymphedema. To date, microsurgical robotic platforms have been used exclusively for the anastomosis of vessels in lymphatic surgery. This study reports on the first total robotic-assisted lymphovenous anastomosis and further highlights future directions for microsurgical robotic assistance in lymphatic surgery.

methodsUsing the Symani® Surgical System, two patients with lower extremity lymphedema received total robotic-assisted lymphovenous anastomoses. This included robotic-assisted microdissection of lymphatic and venous vessels followed by performance of a robotic-assisted lymphovenous anastomosis.

resultsA total of four complete robotic-assisted lymphovenous anastomoses were performed in the lower legs of two patients. All anastomoses showed patency in the intraoperative indocyanine green imaging, demonstrating the feasibility of total robotic-assisted lymphovenous anastomosis.

conclusionTotal robotic-assisted lymphovenous anastomosis is a safe and feasible surgical technique. Microsurgical robotic assistance enhances the surgeon's precision and improves the ergonomics, thus ameliorating surgical endurance. Further studies are required to compare this new technique to a traditional manual approach regarding the surgical outcome and cost efficiency. Future technical refinements such as a greater variety of microsurgical instruments and the possibility of automated robotic surgery could further expand the application of robotic assistance in lymphatic surgery.

Indexed as

Anastomosis, SurgicalLymphatic VesselsLymphedemaMicrosurgeryRobotic Surgical ProceduresVeinsFemaleHumansIndocyanine GreenMaleMiddle AgedIndocyanine GreenLVALymphedemaLymphovenous anastomosisRoboticRobotic-assistedRoboticsSupermicrosurgerySymani

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