{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T20:14:17Z","timestamp":1784578457248,"version":"3.55.0"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T00:00:00Z","timestamp":1756252800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Robotic Surg"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Robotic surgery has introduced significant innovations in hand microsurgery, enabling complex procedures such as nerve sutures and arterial and venous anastomoses to be performed with greater precision and control. The Symani\u00ae Surgical System represents a promising advancement over conventional techniques by offering enhanced dexterity, tremor elimination, and motion scaling to improve microsurgical outcomes. While most studies in the literature focus on clinical comparisons between traditional and robotic approaches, our work aims to explore the practical aspects of integrating the Symani\u00ae into hand surgery. Specifically, we describe the structured training pathway for both surgeons and nursing staff, along with a detailed setup of the operating room, including optimal team positioning and coordination. Our early experience suggests that, following a dedicated learning curve, the Symani\u00ae system can be successfully implemented in microsurgical clinical practice. Proper team training and operating room organization are essential to maximize the system\u2019s benefits in terms of safety, efficiency, and surgical precision.<\/jats:p>","DOI":"10.1007\/s11701-025-02629-2","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:43:00Z","timestamp":1756316580000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of the Symani\u00ae microscopic surgical robot in hand surgery and operating room setup"],"prefix":"10.1007","volume":"19","author":[{"given":"Alessandro","family":"Piperno","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Palombo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessia","family":"Pagnotta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,8,27]]},"reference":[{"key":"2629_CR1","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1177\/15533506241262568","volume":"31","author":"N Dastagir","year":"2024","unstructured":"Dastagir N, Obed D, Tamulevicius M et al (2024) The use of the Symani Surgical System\u00ae in emergency hand trauma care. Surg Innov 31:460\u2013465. https:\/\/doi.org\/10.1177\/15533506241262568","journal-title":"Surg Innov"},{"key":"2629_CR2","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1007\/s11701-024-02175-3","volume":"19","author":"F Struebing","year":"2024","unstructured":"Struebing F, Boecker A, Vollbach F et al (2024) Robot-assisted microsurgery: a single-center experience of 100 cases. J Robot Surg 19:28. https:\/\/doi.org\/10.1007\/s11701-024-02175-3","journal-title":"J Robot Surg"},{"key":"2629_CR3","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1080\/10447318.2018.1455307","volume":"34","author":"JR Lewis","year":"2018","unstructured":"Lewis JR (2018) The system usability scale: past, present, and future. Int J Human-Comput Interact 34:577\u2013590. https:\/\/doi.org\/10.1080\/10447318.2018.1455307","journal-title":"Int J Human-Comput Interact"},{"key":"2629_CR4","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/1748-5908-9-52","volume":"9","author":"R Randell","year":"2014","unstructured":"Randell R, Greenhalgh J, Hindmarsh J et al (2014) Integration of robotic surgery into routine practice and impacts on communication, collaboration, and decision making: a realist process evaluation protocol. Implement Sci IS 9:52. https:\/\/doi.org\/10.1186\/1748-5908-9-52","journal-title":"Implement Sci IS"},{"key":"2629_CR5","doi-asserted-by":"publisher","DOI":"10.1055\/b-002-79367","volume-title":"The art of microsurgical hand reconstruction","author":"DJ Slutsky","year":"2013","unstructured":"Slutsky DJ (2013) The art of microsurgical hand reconstruction. Thieme Publishing Group"},{"key":"2629_CR6","doi-asserted-by":"publisher","first-page":"168","DOI":"10.23736\/S2784-8469.23.04293-1","volume":"74","author":"A Pagnotta","year":"2023","unstructured":"Pagnotta A, Molayem I, Tos P (2023) Microsurgery in wrist and hand non-union and bone necrosis. Minerva Orthop 74:168\u2013179. https:\/\/doi.org\/10.23736\/S2784-8469.23.04293-1","journal-title":"Minerva Orthop"},{"key":"2629_CR7","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1016\/j.hansur.2022.06.001","volume":"41","author":"A Pagnotta","year":"2022","unstructured":"Pagnotta A, Formica VM, Ascione A et al (2022) Massive bone allograft engineered with autologous vessels: a new perspective for the future. Hand Surg Rehabil 41:648\u2013653. https:\/\/doi.org\/10.1016\/j.hansur.2022.06.001","journal-title":"Hand Surg Rehabil"},{"key":"2629_CR8","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1142\/S0218810411004984","volume":"16","author":"I Panchulidze","year":"2011","unstructured":"Panchulidze I, Berner S, Mantovani G, Liverneaux P (2011) Is haptic feedback necessary to microsurgical suturing? comparative study of 9\/0 and 10\/0 knot tying operated by 24 surgeons. Hand Surg 16:1\u20133. https:\/\/doi.org\/10.1142\/S0218810411004984","journal-title":"Hand Surg"}],"container-title":["Journal of Robotic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-025-02629-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11701-025-02629-2","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11701-025-02629-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,4]],"date-time":"2026-01-04T01:23:13Z","timestamp":1767489793000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11701-025-02629-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,27]]},"references-count":8,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["2629"],"URL":"https:\/\/doi.org\/10.1007\/s11701-025-02629-2","relation":{},"ISSN":["1863-2491"],"issn-type":[{"value":"1863-2491","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,27]]},"assertion":[{"value":"18 June 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 August 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Jewish Hospital of Rome does not require ethical approval for brief communications that do not involve human participants, patient data, or identifiable personal information. This article provides a descriptive overview of the operative setting in robotic microsurgery using the Symani\u00ae surgical system and does not include any clinical data or reference to individual patients.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was not required for this article as no individual patient data, images, or identifiable information are included.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}],"article-number":"519"}}