Supermicrosurgery in reconstructive surgery: a comprehensive bibliometric analysis
Related Experiment Video
Updated: Nov 6, 2026
A Pre-clinical Rat Model for the Study of Ischemia-reperfusion Injury in Reconstructive Microsurgery
Published on: November 8, 2019
Dilip Gosall1, Oluwatobi Adegboye2, Michalis Hadjiandreou2
1St John's College, The University of Cambridge, Cambridge, UK.
Background:
Supermicrosurgery represents an important advancement within the field of reconstructive surgery. This advancement has enabled anastomosis of vessels ≤0.8 mm and has broadened applications in lymphatic surgery, perforator-based reconstruction and technology-based microsurgery. Clinical applications have advanced substantially, but the evolution of the field has not been comprehensively characterised.
Methods:
A bibliometric analysis was conducted to assess the global supermicrosurgery literature. A systematic search of PubMed, Web of Science and the Cochrane Library was performed on 1 April 2026 using the search terms 'supermicrosurgery' OR 'supramicrosurgery'. Publications describing clinical, translational, technical, or imaging-related applications within the field of supermicrosurgery were included. Data extracted comprised publication characteristics, citation metrics, anatomical distribution, technique classification, and Oxford Centre for Evidence-Based Medicine levels of evidence. Descriptive analyses of temporal and thematic trends were undertaken.
Results:
A total of 175 studies published between 1998 and 2026 were included, accumulating 3578 citations. Publication output increased after 2013 and reached its highest level between 2023 and 2024. The largest domain was lymphatic applications (58.3%), followed by reconstructive applications (30.3%). The most commonly studied anatomical regions were lower limb and combined extremities. There was a marked growth in technology-enabled supermicrosurgery after 2020 and this included robotic and digitally assisted techniques. Level IV observational studies predominated in the literature, accounting for 54.3% of included studies. Japan was the leading contributor followed by South Korea, Italy, and the United States.
Conclusion:
Supermicrosurgery has developed from a specialised reconstructive technique into a broad technical framework with expanding applications in lymphatic surgery and technology-assisted surgery. Despite rapid academic growth, the field remains limited by a predominance of lower-quality evidence, highlighting the need for higher-quality comparative and prospective research.