ArticleArchives of plastic surgery2026
The Current Landscape of Robotics in Lymphatic Supermicrosurgery: A Systematic Review.
Article in Archives of plastic 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.
What it found
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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.
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Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Lymphedema affects over 250 million people worldwide and is increasingly managed with physiologic procedures such as lymphovenous bypass (LVB) and vascularized lymph node transfer (VLNT). These supermicrosurgical techniques require advanced training, are ergonomically demanding, and can be limited in anatomically constrained regions. Robotic surgical systems offer high-resolution visualization, motion scaling, tremor reduction, and improved ergonomics, making them promising adjuncts for lymphatic supermicrosurgery. However, evidence on safety, feasibility, and outcomes remains limited. Methods: A systematic review was conducted in accordance with PRISMA guidelines using PubMed, Cochrane Library, and Embase from inception through December 2024. Eligible studies included human clinical reports of robotic-assisted peripheral lymphatic reconstruction. Extracted data included demographics, operative details, outcomes, and study quality. Results: Seven studies involving 134 patients and 221 anastomoses were included, of which 78% (172) were performed robotically. The Symani system was most frequently used. Robotic procedures comprised 59.9% LVBs and 32% VLNTs or other free flaps. Across studies, mean anastomotic time was longer with robotic assistance (25.7 minutes) compared with manual techniques (11 minutes); however, three studies demonstrated significant time reduction with experience, ultimately approaching manual times. When reported, clinical outcomes, including limb volume reduction and quality-of-life measures, were comparable between robotic and manual groups. Advantages included tremor elimination and improved ergonomics, while challenges included cost, setup time, and lack of haptic feedback. Conclusions: Robotic-assisted lymphatic supermicrosurgery is safe and feasible, with outcomes comparable to conventional surgery. Continued refinement, cost reduction, and standardized outcome reporting will determine its role in expanding therapeutic and preventive lymphatic reconstruction.
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