Microsurgery Zurich: Symani robot in use for the first time
A few days ago, Nicole Lindenblatt and her team performed one of the world's first microsurgical operations using a robot. The robot enables the surgeons to operate on even finer vessels than before.
Operations on small blood vessels, nerves and the lymphatic system are performed using microsurgery. The surgeons sew together structures with a diameter of less than 0.8 mm. They work with ultra-fine needles and sutures. Until now, these operations have been performed by hand.
On 13 July 2021, the new Symani robot for operations at the University Hospital Zurich (USZ) was delivered. After Prof. Dr. med. Lindenblatt, Deputy Director of the Clinic for Plastic Surgery and Hand Surgery, and her team had thoroughly tested the robot, the medical team was able to operate on the first patient with it on 3 August 2021, as the USZ writes. The patient suffers from chronic lymphedema. In a five-hour operation, the finest connections between lymph vessels and veins on her leg were created and lymph tissue was transplanted by connecting it to fine vessels. The operation went well.
Operating on even finer vessels
"By hand, we basically operate just as well. With the Symani robot, however, we can penetrate deeper and operate on even finer vessels," explains Nicole Lindenblatt. This could, for example, further improve the operation of the thoracic duct or enable operations on very small blood vessels for less invasive flap plastics. According to the USZ, patients benefit from the fact that operations can be performed that were previously not possible. For the surgeons, the robot also brings the advantage that the operation is more ergonomic and comfortable. The robot is controlled entirely by the surgeon. She sits on a chair and holds two tweezers in her hand. The movements she makes are transmitted to the microinstruments. The surgical area is magnified up to 30 times on a screen using a camera. Through special glasses, which the surgeons also wear, she sees the image in 3D, according to the USZ.
Quickly accustomed to the Symani robot
Nicole Lindenblatt quickly got used to the Symani robot: "We practiced on 0.5 mm plastic vessels in the Skills Lab. At the beginning, I didn't know exactly how much force to apply to the instruments. The challenge was that I couldn't feel how much pressure was being applied. After a few days, it was possible to sew the vessels precisely without any problems".
At Zurich University Hospital, between 200 and 250 patients undergo microsurgery every year - for breast reconstruction, reconstruction of the head, neck and extremities, and lymphatic surgery. They would all benefit from the new surgical robot, the USZ is convinced. To date, the microsurgery robot Symani has only been used three times worldwide: at the University Hospital Zurich, at the University Hospital Salzburg and at the Ospedaliero Universitaria Careggi (Florence).
Source: USZ
During the operation, Nicole Lindenblatt sits on a chair and holds two tweezers in her hand. The movements she makes are transmitted to the microinstruments. © USZ
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