Robotic surgery has emerged as a promising technique for reconstructive procedures, offering potential advantages across various surgical fields. Following initial case reports on the use of the Symani Surgical System (Medical Microinstruments, S.p.A) for microsurgical anastomosis, the authors evaluated its full potential in extremity reconstruction. They conducted a retrospective analysis of patients with soft tissue defects of the upper and lower extremities treated between February 2022 and May 2024. Each patient underwent soft tissue reconstruction with free tissue transfer with microsurgical anastomosis performed using the Symani Surgical System. The study included 7 male patients and 1 female patient, aged between 19 and 71 years (mean age: 50.6 y). The most used recipient vessels were the anterior tibial artery and vein (37.5%). The preferred anastomotic technique was end-to-side in arterial anastomoses (6/8). All arterial anastomoses were performed using the Symani Surgical System. The mean anastomosis time was 33.2±5.8 minutes. One out of 8 patients required surgical revision outside of the anastomosis. The authors' findings suggest that using the Symani Surgical System for microanastomosis in extremity reconstruction is a safe and effective approach, leading to satisfactory outcomes in different anatomic regions. The system allows for the successful execution of various anastomosis techniques, including end-to-end and end-to-side connections, using single interrupted or running sutures, which enhances its versatility in complex reconstructive procedures. The benefits of robotic assistance in terms of precision and ergonomics are promising for the future of reconstructive microsurgery.
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http://dx.doi.org/10.1097/SCS.0000000000010622 | DOI Listing |
J Robot Surg
December 2024
Department of Hand, Plastic and Reconstructive Surgery, Department of Hand and Plastic Surgery, BG Trauma Center Ludwigshafen, Heidelberg University, Ludwig Guttmann-Straße 13, 67071, Ludwigshafen, Germany.
The adoption of robot-assisted microsurgery (RAMS) is a cutting-edge advancement in the realm of microsurgery. The Symani Surgical System is CE approved and has recently gained FDA approval. It provides tremor elimination, motion scaling and improved ergonomics.
View Article and Find Full Text PDFJ Clin Med
December 2024
BG Trauma Center Ludwigshafen, Department of Hand, Plastic and Reconstructive Surgery, Heidelberg University, Ludwig-Guttmann-Straße 13, 67071 Ludwigshafen, Germany.
: Robot-assisted microsurgery (RAMS) has been introduced into the field of plastic surgery in recent years. It potentially offers enhanced precision and control compared to traditional methods, which is crucial for complex microvascular tasks in free flap reconstructions. We aim to analyze our experiences with robotic-assisted microsurgery in the field of upper extremity free flap reconstruction.
View Article and Find Full Text PDFAnn Plast Surg
January 2025
Centre for Reproductive Medicine and Andrology, Department of Clinical and Surgical Andrology, University Hospital Muenster, Muenster, Germany.
Genital gender-affirming masculinization surgeries require handling of small vessels and nerves handling in deep planes. Since the introduction of the Symani Surgical System for robotic-assisted microsurgery in clinical practice, its value in handling small and deep vessels via additional distal motion axes, motion scaling, and tremor elimination has been demonstrated. We combined the Symani with the robotic exoscope RoboticScope to achieve maximum flexibility and ergonomics for the microsurgeon.
View Article and Find Full Text PDFJ Craniofac Surg
December 2024
Department for Plastic, Hand, and Reconstructive Surgery, BG Trauma Center Ludwigshafen, and Department of Plastic Surgery, University of Heidelberg, Ludwigshafen Germany.
Objective: Microsurgery necessitates precision and skill, with conventional methods often leading to surgeon discomfort due to prolonged static postures. The introduction of robot-assisted microsurgery using the Symani surgical system and a three-dimensional exoscope aims to enhance surgical precision while mitigating these ergonomic issues.
Methods: This prospective, single-center clinical study involved 50 preclinical training sessions and 87 robot-assisted microsurgical procedures at the authors' institution, covering a wide array of interventions from free flap reconstructions to nerve and lymphatic surgeries.
J Craniofac Surg
November 2024
Department of Plastic Surgery, University Hospital Muenster.
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