{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T17:40:04Z","timestamp":1789494004880,"version":"build-2803163510"},"reference-count":42,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Microsurgery"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lymphovenous anastomosis (LVA) is an established microsurgical treatment for lymphedema. Robotic assistance in LVA procedures (RoboLVA) has emerged as a promising advancement, yet its effectiveness and clinical outcomes have yet to be systematically evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review following PRISMA guidelines was conducted using PubMed and manual searching for studies published between January 2000 and December 2024. Included studies reported outcomes of robotic\u2010assisted LVA procedures. Risk of bias was assessed using appropriate tools including RoB 2 and ROBINS\u2010I.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Thirteen studies comprising 257 patients who underwent 225 robotic\u2010assisted lymphovenous anastomoses were included. Mean anastomosis duration ranged from 16 to 25.3\u2009min. Initial patency rates were 97%\u2013100%, with a 12\u2010month patency of 66.6% for RoboLVA versus 81.8% for manual LVA. Volume reduction was achieved in 86% of upper extremity cases (mean: \u22127.6%) and 72% of lower extremity cases (mean: \u22121.4%). Complications were minimal, primarily including vessels anastomotic thrombosis and wound infections. Surgeon satisfaction scores were lower for RoboLVA (3.1\u2009\u00b1\u20090.6) compared to manual LVA (3.8\u2009\u00b1\u20090.8), though ergonomic benefits were noted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>RoboLVA demonstrates comparable technical success and clinical outcomes to manual techniques, with high initial patency rates and a significant number of patients who experienced volume reductions in treated limbs. While operative times are longer, a clear learning curve effect suggests improved efficiency with experience. The technology shows promise for lymphedema treatment, though larger randomized trials with longer follow\u2010up are needed to establish long\u2010term comparative efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70136","type":"journal-article","created":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:14:37Z","timestamp":1762002877000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Robotic\u2010Assisted Lymphovenous Anastomosis: A Systematic Review of Surgical Outcomes"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4085-7338","authenticated-orcid":false,"given":"Suat","family":"Morkuzu","sequence":"first","affiliation":[{"name":"Department of Anatomy, Faculty of Medicine Akdeniz University  Antalya Turkey"},{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berk B.","family":"Ozmen","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ceyda","family":"Buyuker","sequence":"additional","affiliation":[{"name":"School of Medicine Acibadem Mehmet Ali Aydinlar University  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet","family":"Ozturk","sequence":"additional","affiliation":[{"name":"School of Medicine Akdeniz University  Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif Arzum","family":"Fidan","sequence":"additional","affiliation":[{"name":"School of Medicine Akdeniz University  Antalya Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehmet","family":"Ozdemir","sequence":"additional","affiliation":[{"name":"Department of Plastic, Reconstructive and Aesthetic Surgery Atlas University School of Medicine  Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Risal S.","family":"Djohan","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham S.","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-5182","authenticated-orcid":false,"given":"L. 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