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Semin Plast Surg 2023; 37(03): 206-216
DOI: 10.1055/s-0043-1771506
Review Article

Robotics in Microsurgery and Supermicrosurgery

Heather R. Burns
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
2   Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
,
Alexandra McLennan
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
2   Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
,
Erica Y. Xue
1   Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas
2   Division of Plastic Surgery, Texas Children's Hospital, Houston, Texas
,
Jessie Z. Yu
3   Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas
,
Jesse C. Selber
4   Department of Plastic Surgery, Corewell Health, Grand Rapids, Michigan
› Author Affiliations Funding None.
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Abstract

Microsurgery has changed the ability to perform highly precise and technical surgeries through the utilization of high-powered microscopes and specialized instruments to manipulate and repair anatomical structures as small as a few millimeters. Since the first human trials of robotic-assisted microsurgery in 2006, the expansion of microsurgery to supermicrosurgery (luminal diameter less than 1 mm) has enabled successful repair of previously inaccessible structures. Surgical robotic systems can offer two distinct operative advantages: (1) minimal access surgery—by entering body cavities through ports, flap harvest can be redesigned to affect a minimally invasive approach for flaps such as the rectus abdominis muscle, the latissimus flap, and the deep inferior epigastric perforator flap; and (2) precision—by eliminating physiologic tremor, improving ergonomics, increasing accessibility to difficult spaces, and providing motion scaling, precision is significantly enhanced. Robotic-assisted microsurgery is a promising application of robotics for the plastic surgeon and has played an important role in flap harvest, head and neck reconstruction, nerve reconstruction, gender-affirming surgery, and lymphatic reconstruction—all the while minimizing surgical morbidity. This article aims to review the history, technology, and application of microsurgery and supermicrosurgery in plastic surgery.

Keywords

robotic microsurgery - robotic breast reconstruction - supermicrosurgery - robotic plastic surgery


Publication History

Article published online:
04 March 2024

© 2023. Thieme. All rights reserved.

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