{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T08:58:42Z","timestamp":1790585922532,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"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":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dedicated robotic\u2010assisted microsurgical systems (RAMS), including the Symani Surgical System and MUSA, were developed to overcome physiological tremor, surgeon fatigue, and restricted maneuverability in deep surgical fields. Existing reviews of robotic plastic surgery largely span heterogeneous applications beyond microsurgery or lack structured risk\u2010of\u2010bias appraisal specific to dedicated microsurgical platforms. This review systematically synthesizes clinical outcomes, learning\u2010curve dynamics, and technological features of dedicated RAMS platforms in microsurgery, incorporating structured risk\u2010of\u2010bias appraisal to clarify the evidence base and inform clinical adoption.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Studies published 2015\u20132025 were identified through PubMed, Embase, Scopus, and Web of Science (PROSPERO CRD420261320086). Following independent screening, 21 studies were included, assessing free flap survival, anastomotic patency, complications, operative times, and learning\u2010curve metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Free flap reconstruction showed high survival (96%\u2013100%); supermicrosurgical anastomosis patency was 96.6%\u2013100%. Robotic anastomosis times fell 51%\u201366% with experience (largest reduction 66.1%, for deep\u2010plane arterial anastomosis), though times remained longer than manual benchmarks even after the learning phase (e.g., 25.3\u2009\u00b1\u200912.3 vs. 14.1\u2009\u00b1\u20094.3\u2009min for mixed procedures). Conversion\/failure was infrequent (0%\u20134.3%). Motion scaling (up to 20\u00d7) and tremor filtration were consistent advantages; haptic feedback remained universally absent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Dedicated RAMS platforms are safe and effective for micro\u2010 and supermicrosurgical reconstruction, non\u2010inferior to manual techniques. Initial time penalties resolve with experience. Future research should prioritize randomized controlled trials, standardized outcome measures, and cost\u2010effectiveness analyses.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/micr.70286","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T04:18:53Z","timestamp":1787890733000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Dedicated Robotic\u2010Assisted Microsurgery Platforms in Plastic and Reconstructive Surgery: A Systematic Review"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0362-0977","authenticated-orcid":false,"given":"Simon M.","family":"Kratzer","sequence":"first","affiliation":[{"name":"Division of Surgery &amp; Interventional Science, Royal Free London NHS Foundation Trust University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-313X","authenticated-orcid":false,"given":"Mehmet","family":"Ergisi","sequence":"additional","affiliation":[{"name":"Division of Surgery &amp; Interventional Science, Royal Free London NHS Foundation Trust University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8122-991X","authenticated-orcid":false,"given":"Laura","family":"Awad","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, and Division of Surgery and Interventional Science University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0576-1816","authenticated-orcid":false,"given":"Deepak M.","family":"Kalaskar","sequence":"additional","affiliation":[{"name":"Division of Surgery &amp; Interventional Science, Royal Free London NHS Foundation Trust University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7419-1493","authenticated-orcid":false,"given":"Peter","family":"Butler","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, and Division of Surgery and Interventional Science University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5819-8740","authenticated-orcid":false,"given":"Dariush","family":"Nikkhah","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Royal Free London NHS Foundation Trust, and Division of Surgery and Interventional Science University College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000006221"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpra.2022.09.002"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000005240"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000006912"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.08.52"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol32070377"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1167\/iovs.12-11136"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1177\/15533506241262568"},{"key":"e_1_2_11_10_1","first-page":"48","article-title":"Robotic\u2010Assisted Microsurgery Using the MUSA\u2010Robot: Evaluation of the Learning Curve in 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