Professor Kwon Jin Geun &#40;right&#41; of Seoul Asan Medical Center performs a lymphaticovenous anastomosis procedure on a patient with lower-limb lymphedema using a supermicrosurgery robot, connecting a lymphatic vessel about 0.4 millimeters wide to a vein. / Courtesy of Seoul Asan Medical Center

South Korean researchers have successfully connected blood vessels thinner than a human hair using a supermicrosurgery robot for the first time in the Asia-Pacific region.

Seoul Asan Medical Center said Thursday that a plastic surgery team led by Professors Hong Joon Pyo, Seo Hyun Seok, Park Chang Sik and Kwon Jin Geun recently performed free flap reconstruction surgery on a female sarcoma patient using the supermicrosurgery robot “Symani.”

The patient showed stable recovery after the operation and was discharged eight days later.

Free flap surgery is a reconstructive procedure in which healthy skin or muscle tissue is transplanted from one part of the body to another. A critical part of the procedure involves precisely connecting the transplanted tissue’s blood vessels to vessels at the surgical site.

The hospital said the surgery was particularly significant because the robot successfully connected ultrafine blood vessels less than 1 millimeter in diameter. Using the robotic system, surgeons precisely sutured arteries and veins measuring between 0.3 and 0.8 millimeters thick.

The patient, a woman in her 50s, had undergone tumor removal surgery after doctors suspected a malignant peripheral nerve sheath tumor in her thigh. To reduce the risk of cancer recurrence, surgeons widely removed surrounding tissue and later performed free flap reconstruction to repair the resulting defect.

Supermicrosurgery is considered one of the most technically demanding surgical fields and is performed under high-magnification microscopes. Fewer than 600 specialists worldwide are believed to be capable of performing such procedures. Surgical outcomes can also vary depending on the operator’s skill level and hand tremors.

The Symani robot used in the procedure is designed for reconstructive surgeries, including breast and limb reconstruction. It translates surgeons’ hand movements into highly refined motions while correcting tremors. The system is specialized for suturing blood and lymphatic vessels ranging from 0.1 to 2.5 millimeters in diameter.

Professor Hong’s team has participated in the robot’s development since its early stages. The device received clinical-use approval from South Korea’s Ministry of Food and Drug Safety in January, and the hospital is currently conducting clinical research on robot-assisted reconstructive surgery.

Professors Hong Joon Pyo, Seo Hyun Seok, Park Chang Sik and Kwon Jin Geun of Seoul Asan Medical Center’s Department of Plastic Surgery. / Courtesy of Provided by Seoul Asan Medical Center

Previously, Seoul Asan Medical Center signed a partnership agreement in November 2023 with Italian supermicrosurgery robotics developer MMI to jointly develop research and education programs and conduct animal testing.

The hospital plans to expand the use of robotic systems beyond free flap reconstruction to a wider range of supermicrosurgical procedures, including lymphaticovenous anastomosis.

Professor Seo said the team aims to establish standardized protocols for robotic supermicrosurgery and share them with medical professionals in South Korea and abroad to provide more patients with advanced treatment options.

South Korean researchers have successfully connected blood vessels thinner than a human ha …

Seoul Asan Team Performs Asia-Pacific’s First Robotic Supermicrosurgery Connecting Submillimeter Vessels