{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T20:42:38Z","timestamp":1784580158791,"version":"3.55.0"},"reference-count":19,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T00:00:00Z","timestamp":1703203200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Surg Innov"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>Background: Robotic systems have successfully been introduced into other surgical fields in the past. First attempts with different setups are made in the field of microsurgery. The Symani\u00ae Surgical System, a flexible platform consisting of two robotic arms, features motion scaling with tremor filtration to address the demands and complexity of microsurgery. Symani\u2019s NanoWrist Instruments are the world\u2019s smallest, wristed surgical instruments, intended to improve a surgeon\u2019s range of motion beyond the capability of the human hand. This combination allows surgeons to scale their hand movements while seamlessly articulating the robotic micro instruments.<\/jats:p>\n                  <jats:p>Purpose: We report on our experience in extremity reconstruction with this novel system.<\/jats:p>\n                  <jats:p>\n                    Research Design: The Symani Surgical System\n                    <jats:sup>\u00ae<\/jats:sup>\n                    was used for 6 cases of extremity reconstruction. The surgeon controlled the manipulators along with the footswitch while either sitting away from the operating table relying on 3D visualization with an exoscope or sitting at the operating table using a standard microscope.\n                  <\/jats:p>\n                  <jats:p>Data Collection: Microsurgical anastomoses were performed in 4 patients (3 end-to-end arterial anastomoses and one end-to-side arterial anastomosis) and nerve grafting was performed in 2 patients.<\/jats:p>\n                  <jats:p>Results: Microvascular anastomoses were slower vs conventional microsurgery, but all anastomoses were patent. Epineural coaptation showed proper fascicle alignment and tissue manipulation could be kept to a minimum. The platform\u2019s motion scaling allows the surgeon to perform precise micro-movements with only minimal tissue manipulation and hard-to-reach anatomy becomes accessible more easily.<\/jats:p>\n                  <jats:p>Conclusions: Robotic microsurgery might gain importance in the nearer future but more data will need to be collected.<\/jats:p>","DOI":"10.1177\/15533506231222438","type":"journal-article","created":{"date-parts":[[2023,12,22]],"date-time":"2023-12-22T03:37:50Z","timestamp":1703216270000},"page":"42-47","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["Robotic Microsurgery in Extremity Reconstruction - Experience With a Novel Robotic System"],"prefix":"10.1177","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3821-7163","authenticated-orcid":false,"given":"Inga S.","family":"Besmens","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olga","family":"Politikou","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Giovanoli","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Calcagni","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0293-1004","authenticated-orcid":false,"given":"Nicole","family":"Lindenblatt","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery and Hand Surgery, University Hospital Zurich, Zurich, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,12,22]]},"reference":[{"key":"bibr1-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1748020"},{"key":"bibr2-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-74244-7_10"},{"key":"bibr3-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1016\/j.anplas.2015.03.005"},{"key":"bibr4-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1055\/s-0028-1104562"},{"key":"bibr5-15533506231222438","unstructured":"MUSA. Developing robots for microsurgery. https:\/\/microsure.nl\/musa\/. Accessed September 3, 2022."},{"key":"bibr6-15533506231222438","volume-title":"Mmi - Medical Micro Instruments","author":"MMI"},{"key":"bibr7-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-12033-x"},{"key":"bibr8-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004013"},{"key":"bibr9-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpra.2022.09.002"},{"key":"bibr10-15533506231222438","volume-title":"Symani System Overview","author":"MMI"},{"key":"bibr11-15533506231222438","doi-asserted-by":"publisher","DOI":"10.20517\/2347-9264.2021.126"},{"key":"bibr12-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1702156"},{"key":"bibr13-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2013.01.012"},{"key":"bibr14-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-74244-7_11"},{"key":"bibr15-15533506231222438","doi-asserted-by":"publisher","DOI":"10.2147\/AMEP.S199323"},{"key":"bibr16-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1055\/s-0040-1719237"},{"key":"bibr17-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-030-73531-9_6"},{"key":"bibr18-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1055\/s-0031-1278244"},{"key":"bibr19-15533506231222438","doi-asserted-by":"publisher","DOI":"10.1016\/j.medcli.2023.06.005"}],"container-title":["Surgical Innovation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15533506231222438","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15533506231222438","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15533506231222438","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:24:09Z","timestamp":1777706649000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15533506231222438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,22]]},"references-count":19,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1177\/15533506231222438"],"URL":"https:\/\/doi.org\/10.1177\/15533506231222438","relation":{},"ISSN":["1553-3506","1553-3514"],"issn-type":[{"value":"1553-3506","type":"print"},{"value":"1553-3514","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,22]]}}}