{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:59:39Z","timestamp":1791907179878,"version":"4.3.4"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T00:00:00Z","timestamp":1712361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T00:00:00Z","timestamp":1712361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006447","name":"University of Zurich","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006447","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Robotic-assisted microsurgery has gained significant attention in recent years following the introduction of two dedicated microsurgical robotic systems specifically designed for this purpose. These feature higher degrees of movement and motion scaling which are useful tools, especially when performing surgery in areas of the body which are difficult to access. Robotic-assisted microsurgery has been implemented in lymphatic surgery as well as soft tissue reconstructive surgery at our institution over the past 2.5\u00a0years. Our study gives an insight into the details and outcomes of the first 100 consecutive (super-) microsurgical anastomoses in peripheral and central lymphatic reconstruction performed with the Symani\n                    <jats:sup>\u00ae<\/jats:sup>\n                    Surgical System between 2021 and 2024. In total, 67 patients were treated, receiving robotic-assisted lymphatic reconstruction with lymphatic tissue transfer (LTT) and\/or lymphovenous anastomoses (LVA)\/lympholymphatic anastomoses (LLA). No anastomosis-associated complications were recorded postoperatively. The majority of patients reported a postoperative improvement of their lymphedema or central lymphatic disorder. In conclusion, we show the successful implementation of the Symani\n                    <jats:sup>\u00ae<\/jats:sup>\n                    Surgical System into our clinical practice of lymphatic reconstruction. Although the necessary intraoperative setup and the use of intrinsic motion scaling lead to a slight increase in operating time, the presented study demonstrates the advantages of robotic assistance which becomes particularly evident in lymphatic surgery due to the involved deep surgical sites and the need for supermicrosurgical techniques.\n                  <\/jats:p>","DOI":"10.1007\/s11701-024-01937-3","type":"journal-article","created":{"date-parts":[[2024,4,6]],"date-time":"2024-04-06T02:01:46Z","timestamp":1712368906000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":59,"title":["100 anastomoses: a two-year single-center experience with robotic-assisted micro- and supermicrosurgery for lymphatic reconstruction"],"prefix":"10.1007","volume":"18","author":[{"given":"Donata","family":"von Reibnitz","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Weinzierl","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlotta","family":"Barbon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian A.","family":"Gutschow","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Giovanoli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisanne","family":"Gr\u00fcnherz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Lindenblatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,4,6]]},"reference":[{"key":"1937_CR1","doi-asserted-by":"publisher","DOI":"10.3389\/Fsurg.2017.00066","author":"TD Dobbs","year":"2017","unstructured":"Dobbs TD, Cundy O, Samarendra H, Khan K, Whitaker IS (2017) A systematic review of the role of robotics in plastic and reconstructive surgery-from inception to the future. Front Surg. https:\/\/doi.org\/10.3389\/Fsurg.2017.00066","journal-title":"Front Surg"},{"key":"1937_CR2","doi-asserted-by":"publisher","DOI":"10.1097\/Gox.0000000000004013","author":"N Lindenblatt","year":"2022","unstructured":"Lindenblatt N, Grunherz L, Wang A, Gousopoulos E, Barbon C, Uyulmaz S, Giovanoli P (2022) Early experience using a new robotic microsurgical system for lymphatic surgery. Plast Reconstr Surg Glob Open. https:\/\/doi.org\/10.1097\/Gox.0000000000004013","journal-title":"Plast Reconstr Surg Glob Open"},{"issue":"2","key":"1937_CR3","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1097\/PRS.0000000000006529","volume":"145","author":"JC Selber","year":"2020","unstructured":"Selber JC (2020) The robotic diep flap. Plast Reconstr Surg 145(2):340\u2013343","journal-title":"Plast Reconstr Surg"},{"key":"1937_CR4","doi-asserted-by":"publisher","DOI":"10.3390\/Jcm11123378","author":"MM Aitzetmuller","year":"2022","unstructured":"Aitzetmuller MM, Klietz ML, Dermietzel AF, Hirsch T, Kuckelhaus M (2022) Robotic-assisted microsurgery and its future in plastic surgery. J Clin Med. https:\/\/doi.org\/10.3390\/Jcm11123378","journal-title":"J Clin Med"},{"key":"1937_CR5","doi-asserted-by":"publisher","DOI":"10.1097\/Prs.0000000000008670","author":"TJM Van Mulken","year":"2022","unstructured":"Van Mulken TJM, Wolfs J, Qiu SS, Scharmga AMJ, Schols RM, Spiekerman Van Weezelenburg MA, Cau R, Van Der Hulst R, G. Microsurgical Robot Research (2022) One-year outcomes of the first human trial on robot-assisted lymphaticovenous anastomosis for breast cancer-related lymphedema. 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Nat Commun. https:\/\/doi.org\/10.1038\/S41467-019-14188-W","journal-title":"Nat Commun"},{"key":"1937_CR8","doi-asserted-by":"publisher","DOI":"10.1002\/Jso.25195","author":"TJM Van Mulken","year":"2018","unstructured":"Van Mulken TJM, Schols RM, Qiu SS, Brouwers K, Hoekstra LT, Booi DI, Cau R, Schoenmakers F, Scharmga AMJ, Van Der Hulst R (2018) Robotic (super) microsurgery: feasibility of a new master-slave platform in an in vivo animal model and future directions. J Surg Oncol. https:\/\/doi.org\/10.1002\/Jso.25195","journal-title":"J Surg Oncol"},{"key":"1937_CR9","doi-asserted-by":"publisher","DOI":"10.1016\/J.Jpra.2022.09.002","author":"C Barbon","year":"2022","unstructured":"Barbon C, Grunherz L, Uyulmaz S, Giovanoli P, Lindenblatt N (2022) Exploring the learning curve of a new robotic microsurgical system for microsurgery. 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The other authors have no financial interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Cantonal Ethics Committee of Zurich (04.01.2022 BASEC-Nr. 2021\u201302351).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was obtained from all individual participants included in the study.\u00a0Patients signed informed consent regarding publishing their data and photographs.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to participate and to publish"}}],"article-number":"164"}}