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Robot-assisted microsurgery: a single-center experience of 100 cases.

F Struebing¹, A Boecker¹, F Vollbach^1,2

¹Department 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.

Journal of Robotic Surgery

|December 17, 2024

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Robot-assisted microsurgery (RAMS) using the Symani Surgical System shows promise in complex procedures like free flaps and nerve surgery. This study of 100 cases demonstrates a viable alternative to traditional microsurgery with a good safety profile.

Area of Science:

Microsurgery
Robotic Surgery
Surgical Technology

Background:

Robot-assisted microsurgery (RAMS) represents an advancement in microsurgical techniques.
The Symani Surgical System offers tremor elimination, motion scaling, and improved ergonomics.
Recent CE and FDA approvals highlight the system's growing acceptance.

Purpose of the Study:

To report on the first 100 consecutive cases of RAMS at a high-volume academic center.
To assess the clinical application and efficacy of RAMS.
To evaluate the safety profile and outcomes of RAMS in diverse microsurgical procedures.

Main Methods:

A prospective database collected data on 100 consecutive RAMS cases between February 2023 and April 2024.
Data included patient demographics, surgical details, and outcomes.

Keywords:

Free flap surgery Plastic surgery Reconstructive surgery Robot-assisted microsurgery Robotic microsurgery Supermicrosurgery

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Surgeons underwent a 12-hour training program prior to system use.

Main Results:

RAMS was performed in 100 patients (mean age 54 years, 66% male), primarily for free flaps (73%), nerve surgery (20%), and lymphovenous anastomoses (LVA) (6%).
159 anastomoses were performed with a 12% major complication rate; 2.7% of free flaps were lost completely, and 1.4% partially.
LVAs showed significantly longer times per stitch (p<0.01). Conversion rate to conventional techniques was 3%.

Conclusions:

RAMS is a feasible and viable alternative to traditional microsurgery in a high-volume setting.
The system demonstrates a commendable safety profile, with complication rates comparable to existing literature.
Challenges include longer anastomosis times and higher costs, but overall efficacy is affirmed.