Related Experiment Video
Updated: Apr 28, 2026
03:07
Single-Port Robotic-assisted Transaxillary Breast-conserving Surgery: A Prospective, Single-arm, Non-randomized Phase IIa Clinical Trial
Published on: August 19, 2025
1.5K
Evolution of Robotic-Assisted Sympathetic Trunk Reconstruction: Technical Innovation and Clinical Experience.
Lisa Wen-Yu Chen1, Cheyenne Wei-Hsuan Sung1, Yin-Kai Chao2
1Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital-Linkou, Chang Gung Medical College and University, Taoyuan, Taiwan.
Seminars in Plastic Surgery
|April 27, 2026
Summary
Robotic sympathetic trunk reconstruction effectively treats severe compensatory sweating after endoscopic thoracic sympathectomy. Innovations like vascularized intercostal nerve grafts improve outcomes and reduce patient morbidity.
Area of Science:
- Thoracic surgery
- Microsurgery
- Regenerative medicine
Background:
- Endoscopic thoracic sympathectomy (ETS) is effective for palmar hyperhidrosis but causes severe compensatory sweating and autonomic dysfunction in over 80% of patients.
- Current management for post-sympathectomy complications is limited.
Purpose of the Study:
- To present the institutional evolution and outcomes of robotic-assisted sympathetic trunk reconstruction (STR) for managing post-ETS complications.
- To evaluate the efficacy of different nerve grafting techniques, including vascularized intercostal nerve (vICN) grafts.
Main Methods:
- A prospective series of 23 patients underwent robotic STR with nerve grafting.
- The study evolved from free nerve grafts to vICN grafts to minimize donor site morbidity.
- Propensity score-matched analysis compared vICN versus free intercostal grafts.
- Recent adoption of single-port robotic systems to reduce chest wall morbidity.
Main Results:
- Robotic STR demonstrated significant improvement in chest and back sweating severity at 6 months (p < 0.001), with sustained gains at 2 years.
- vICN grafting achieved 100% technical success with no vascular complications and showed continuous improvement without temporary worsening.
- Single-port robotic systems reduced postoperative chest wall morbidity.
Conclusions:
- Robotic-assisted STR is a viable treatment for carefully selected patients with severe post-sympathectomy complications.
- Innovations in microsurgical technique, robotic precision, and grafting strategies enhance patient recovery and minimize morbidity.
- vICN grafting represents a promising advancement for sympathetic trunk reconstruction.
