Transforming breast reconstruction: The role of robotic-assisted surgery in the breast cancer journey

This Breast Cancer Awareness Month, we at MMI are proud to spotlight the role that robotic-assisted surgery is playing in the future of breast reconstruction. With The Symani® Surgical System, surgeons can lead the way to better outcomes and quality of life for their patients, by offering an innovative, technology-enabled option for autologous breast reconstruction to breast cancer survivors. 

Globally, breast cancer is the most common cancer among women. In the U.S. alone, it is estimated that 1 in 8 women will develop breast cancer in their lifetime.¹ With survival rates improving due to early detection and advancements in treatment, a growing number of patients are seeking breast reconstruction options following mastectomy to restore their full sense of self. 

However, up to 30% of breast cancer survivors may develop lymphedema,² a painful and chronic condition characterized by swelling in the arms or chest caused by damage to the lymphatic system during surgery or radiation therapy. This is where robotic-assisted breast reconstruction can help offer an innovative solution—not only providing a technology-enabled approach to autologous breast reconstruction, but also preventing or treating lymphedema. 

For surgeons committed to providing comprehensive care, adopting robotic technology with Symani is not just about enhancing surgical outcomes—it’s about changing lives. 

Considerations for choosing autologous reconstruction over implant-based reconstruction 

For many patients, autologous breast reconstruction is the preferred option because it uses the patient’s own tissue, offering a more natural look and feel. Yet, only 20% of patients choose this option3, likely due to the limited availability of skilled surgeons and lack of awareness about the procedure. As a result, many opt for implants, which are perceived as quicker and more convenient. However, unlike implants, which may require replacement over time, autologous tissue reconstruction provides a permanent solution with a lower risk of long-term failure and is associated with greater patient satisfaction.^2,3

This approach is particularly beneficial for women who want to avoid the potential complications associated with implants. Autologous reconstruction can adapt more naturally to body changes over time, helping to deliver a long-lasting result that grows with the body and gives patients greater peace of mind. 

The precision needed to tackle challenging cases 

Achieving natural, aesthetically pleasing, and long-lasting results in breast reconstruction can be challenging, particularly in complex cases like autologous free flap surgeries. With robotic assistance, surgeons are equipped with enhanced precision and control to perform these intricate procedures. Symani offers enhanced precision for optimal outcomes to assist patients in achieving their goals of improved self-image and confidence, and restored quality of life. 

Comprehensive cancer care: preventing and treating symptoms of lymphedema 

For breast cancer patients, lymphedema—painful, chronic swelling from lymph fluid buildup—is a long-term risk following their cancer treatment. Unfortunately, the complexity of lymphatic repair limits surgical options, with fewer than 5,000 surgeries performed annually in the US⁴ and only around 600 surgeons worldwide skilled in supermicrosurgery.⁵ This leaves many patients dependent on compression therapy or manual lymphatic drainage, which can impact their quality of life. 

Robotic-assisted surgery offers a new approach. With Symani, we’re opening the door to surgical options for lymphatic conditions. Symani’s precision, stability, and ability to access deep anatomical structures are key in advancing lymphatic repair. Its NanoWrist® Instruments, the world’s smallest robotic wrists, mimic natural hand movements with seven degrees of freedom. Features like tremor reduction and 7-20x motion scaling allow surgeons to handle even the smallest vessels with confidence. Learn more about Symani. 

Additionally, in a study of 67 patients with 100 lymphatic anastomoses performed with Symani, Lindenblatt et al. showed 86% of upper extremity and 72% of lower extremity cases had a reduction in limb volume and 42% of patients were able to reduce compression garment class.⁶

Advancements in robotic technology may help expand access to supermicrosurgery for lymphatic repair, allowing hospitals to offer comprehensive care for more breast cancer patients. 

Robotic-assisted microsurgery: Key advantages for surgeons 

Many surgeons are realizing the benefits of incorporating robotics into their reconstructive practices: 

Expanded capabilities
Symani offers surgeons the ability to tackle complex cases, particularly those involving intricate soft tissue procedures like breast reconstruction and lymphatic system repair. Symani enhances precision and control, enabling surgeons to perform tasks that are challenging or nearly impossible with manual techniques. It offers the potential to expand into less invasive approaches to breast reconstruction by using perforator vessels or the ability to expand into supermicrosurgical applications for lymphatic repair.  

Enhanced precision and stability 
Symani mimics the natural hand and wrist movements of the surgeon at a micro scale, allowing for extreme precision. The system reduces hand tremors and provides motion scaling, which gives surgeons greater control, even in the most delicate procedures, to help improve accuracy and strengthen confidence during surgery. 

Potential to improve patient outcomes
The ability to work with finer precision helps protect vessels, reducing vessel trauma and the risk of adverse events. This may result in fewer secondary procedures, enhancing long-term outcomes for your patients. 

Why surgeons are adopting robotic-assisted breast reconstruction

By adopting robotic technology, surgeons can provide patients with comprehensive treatment options that can include preventative measures for lymphedema. 

The result? Patients experience more than just a successful reconstruction—they regain confidence, comfort, and control over their recovery. Watch Janine’s story to learn more about her journey with robotic-assisted breast reconstruction. 

Partnering with hospitals to advance breast reconstruction 

We’re working with hospitals to integrate robotic-assisted microsurgery into their breast cancer care programs. By combining precision technology with surgeon expertise, we’re helping institutions deliver exceptional results in breast reconstruction, making them leaders in comprehensive cancer care while expanding expand access to treatment options for their patients. 

As we recognize Breast Cancer Awareness Month, we encourage hospitals and surgeons to further explore the benefits of robotic-assisted surgery. Together, we can reshape the future of breast reconstruction to improve the lives of breast cancer survivors. 

Interested in learning more about our robotic-assisted platform and how it can enhance your breast reconstruction practice? Learn more about starting a robotics program.  

References

1. American Cancer Society 
2. Zou, L., Liu, Fh., Shen, Pp. et al. The incidence and risk factors of related lymphedema for breast cancer survivors post-operation: a 2-year follow-up prospective cohort study. Breast Cancer 25, 309–314 (2018). 
3. Broyles, J. M., Balk, E. M., Adam, G. P., Cao, W., Bhuma, M. R., Mehta, S., Dominici, L. S., Pusic, A. L., & Saldanha, I. J. (2022). Implant-based versus Autologous Reconstruction after Mastectomy for Breast Cancer: A Systematic Review and Meta-analysis. Plastic and reconstructive surgery. Global open, 10(3), e4180. 
4. M. Salgarello, SIM 2015, Torino 26-28 November 2015, The venous lymph node flap: concepts, experimental evidence, and clinical translation (5) G. Visconti, M. Salgarello, T. Constantinescu, Hung-Chi Chen 
5. Badash, I., Gould, D. J., & Patel, K. M. (2018). Supermicrosurgery: History, Applications, Training and the Future. Frontiers in surgery, 5, 23. https://doi.org/10.3389/fsurg.2018.00023 
6. Nicole Lindenblatt, MD, et al. 100 anastomoses: a two-year single-center experience with robotic-assisted micro- and supermicrosurgery for lymphatic reconstruction. J Robotic Surg 18, 164 (2024). https://doi.org/10.1007/s11701-024-01937-3