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First-of-Its Kind Robotic Technology Uniquely Addresses Scale and Complexities of Microsurgery and Supermicrosurgery

By HospiMedica International staff writers
Posted on 26 Sep 2023

Microsurgery involves the manipulation or suturing of extremely small anatomical structures like arteries, veins, and nerves. The work demands keen eyesight and specialized instruments, not to mention finely tuned motor skills. Supermicrosurgery takes this to an even more microscopic level. Unfortunately, many patients with complex health issues lack access to optimal treatments due to the human limitations involved in performing such precise surgeries and the scarcity of specialists in the field. Now, a first-of-its kind robotic technology has been designed to tackle the specific needs and challenges of microsurgery and supermicrosurgery. This technology aims to improve the quality of life for patients, empower more surgeons to execute complex microsurgeries, and allow hospitals to broaden their surgical offerings.

Medical Microinstruments, Inc.’s (MMI, Misa, Italy) Symani Surgical System is a robotic platform designed to expand treatment possibilities for patients requiring soft tissue surgeries such as free flap reconstructions, lymphatic surgeries, trauma-related reconstructions, and repairs of peripheral nerves. What sets the Symani Surgical System apart is its specialized NanoWrist instruments, which boast the smallest surgical robotic wrist in the world. These NanoWrists allow the surgeons to mimic natural hand movements at microscopic scales. They offer seven degrees of freedom, the ability to filter out hand tremors, and motion scaling, thus enhancing both precision and control.


Image: The Symani Surgical System is a flexible platform consisting of two robotic arms (Photo courtesy of MMI)
Image: The Symani Surgical System is a flexible platform consisting of two robotic arms (Photo courtesy of MMI)

The Symani Surgical System is equipped with two robotic arms that can be adjusted to suit various surgical needs across different anatomical areas. Designed with ease of use and setup in mind, it also includes the Symani Console—a seat and control panel equipped with footswitch controllers where the surgeon sits. From this console, surgeons can manipulate the robotic arms in much the same way they would manually handle surgical instruments. The console can either be positioned next to the patient or be paired with a 3D visualization system for a "heads-up" view. Since its first usage in human patients in October 2020, the Symani System has been deployed in over 500 surgeries, steadily increasing the number of patients who have access to these advanced surgical treatments as more and more surgeons become accustomed to the technology.

“We believe that open surgery is long overdue for technological advancement. This major milestone for the Symani Surgical System is a testament to how robotics can elevate the standard of care by pushing the boundaries of complexity,” said Mark Toland, CEO of MMI. “People with hard-to-treat conditions deserve options that can give them a better quality of life, and we hope that by expanding access to microsurgical and supermicrosurgical procedures, we’re able to drive that initiative forward.”

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