Generalization of supermicrosurgery with robotic assistance

Supermicrosurgery is an advanced technique that enables the reconstruction and transplantation of tissues by anastomosing blood vessels and nerves 0.3–0.8 mm in diameter using specialized microscopes. This intricate procedure is mastered by only a select few plastic surgeons. However, the potential applications of this technology are widespread, including reconstructive surgery after resection of malignant tumors, organ transplantation, reattachment of amputated digits, and treatment of lymphedema; therefore, more surgeons need to learn such procedures. This study demonstrated that non-plastic surgeons were able to perform supermicrovascular anastomosis in vivo within a short period using a surgical assistant robot. During the robot’s development, emphasis was placed on reducing the difficulty of surgeon’s tasks, utilizing prior experience, enabling intuitive operation, and maintaining concentration. The robot, equipped with a user-friendly interface, was optimized for precise movements and featured advanced motion tracking capabilities and an automatic instrument exchange function. Twelve non-plastic surgeons participated, and after a few hours of training with the robot and practicing vascular anastomosis, they were able to successfully perform an anastomosis of a 0.6-mm rat femoral artery. Robotic assistance will facilitate the widespread adoption of supermicrosurgery. It has the potential to transform surgical practices and benefit more patients in the future.