MMI
Symani
Chronology
Posted Oct 2024 Updated Feb 2025
FDA authorization. April 8, 2024.
MMI founded in Pisa (Italy). 2015.
The Symani™ Surgical System developed by Medical MicroInstruments (MMI), is a cutting-edge device designed for microsurgery and supermicrosurgery. It features two tele-manipulated surgical arms specifically engineered for precision in delicate procedures.
Miniaturization is a key innovation of the Symani system. The wristed instruments, though similar in basic design to other robotic tele-manipulated systems, are specially adapted for use in microsurgery and supermicrosurgery—capable of handling structures smaller than 1 mm. Given the nature of these procedures, the instruments do not require a wide range of motion but are optimized for precise work within a small surgical field. Another standout feature is motion scaling, offering up to 20x scaling for enhanced precision.
The system does not include integrated vision. Instead, it must be paired with an external magnification device, such as a microscope or exoscope, for visual aid. The surgeon’s console is notable for its simplicity, comprising just a chair with armrests and two manipulators. Additionally, the system includes two foot pedals: one to “get-in” and “get-out”, and a clutch.
It has clinical applications in breast cancer, lymphedema, Head&Neck Cancer and Trauma. FDA approval in the US is for “soft tissue manipulation to perform microsurgery techniques such as anastomosis, suturing, and ligation on small blood vessels and lymphatic ducts, with diameters ranging between 0.1 and 2.5mm, in open free-flap surgery of the breast and extremities and open lymphatic surgery of the extremities. The Symani Surgical System is indicated for use during microsurgical procedures when use of a motion scaling function is deemed appropriate by the surgeon“. And CE mark is for “soft tissue manipulation to perform microsurgery techniques such as anastomosis, suturing, and ligation on small anatomical structures, including blood vessels, lymphatics ducts, and nerves in open surgery procedures. The Symani Surgical System is indicated for use during microsurgical procedures when use of a motion scaling function is deemed appropriate by the surgeon. The System is indicated for adult and pediatric use. It is intended to be used by trained physicians in an appropriate operating environment in accordance with the Instructions for Use. The Symani Surgical System is not intended for use on the heart, central circulatory system, and central nervous system“
See how it works (video demo)
Links:
Locations:
MMI
5022 Gate Parkway,
Building 500,
Jacksonville, FL 32256
References:
Lindenblatt N, Grünherz L, Wang A, Gousopoulos E, Barbon C, Uyulmaz S, Giovanoli P. Early Experience Using a New Robotic Microsurgical System for Lymphatic Surgery. Plast Reconstr Surg Glob Open. 2022 Jan 10;10(1):e4013. doi: 10.1097/GOX.0000000000004013.
Wessel KJ, Wendenburg I, Varnava C, Wellenbrock S, Dermietzel A, Hiort M, Kampshoff D, Wiebringhaus P, Hirsch T, Kueckelhaus M. Ideal suturing technique for robot-assisted microsurgical anastomoses. J Robot Surg. 2024 Jun 29;18(1):272. doi: 10.1007/s11701-024-02012-7.
J Granell
Robotic Surgeon
Prior to commencing my venture into robotic surgery, I had established a firm grounding as an oncologic surgeon. My experience encompassed a wide range of resective and reconstructive procedures, as well as proficiency in minimally invasive surgical techniques and endoscopic surgery. These acquired skills and expertise serve as fundamental pillars for achieving success in robotic surgery.
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