Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review

<b>Background</b>: Robotic surgical systems offer enhanced precision, motion scaling, tremor filtration, and visualization, making them highly suitable for the complex anatomical demands of plastic and reconstructive surgery. While widely implemented in other specialties, their integrati...

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Main Authors: Ishith Seth, Kaiyang Lim, Edmond Chang, Warren M. Rozen, Sally Kiu-Huen Ng
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Sensors
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Online Access:https://www.mdpi.com/1424-8220/25/10/3238
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author Ishith Seth
Kaiyang Lim
Edmond Chang
Warren M. Rozen
Sally Kiu-Huen Ng
author_facet Ishith Seth
Kaiyang Lim
Edmond Chang
Warren M. Rozen
Sally Kiu-Huen Ng
author_sort Ishith Seth
collection DOAJ
description <b>Background</b>: Robotic surgical systems offer enhanced precision, motion scaling, tremor filtration, and visualization, making them highly suitable for the complex anatomical demands of plastic and reconstructive surgery. While widely implemented in other specialties, their integration in plastic surgery remains limited. This systematic review evaluates the clinical applications, outcomes, and limitations of robotic-assisted techniques in plastic and reconstructive procedures. <b>Methods</b>: Following PRISMA guidelines, a systematic search was conducted across PubMed, Embase, Scopus, and Web of Science for studies published between January 1980 and March 2025. Clinical studies reporting robotic applications in plastic surgery were included, while cadaveric, animal, and non-English studies were excluded. Data extraction and quality assessment were performed using Covidence and validated tools including the CARE checklist, NOS, GRADE, and SYRCLE. A total of 1428 studies were screened, and 31 met the inclusion criteria. <b>Results</b>: Robotic systems were primarily applied in microsurgery (<i>n = 16</i>), breast reconstruction (<i>n = 8</i>), and craniofacial/aesthetic surgery (<i>n = 7</i>). Common platforms included the Symani Surgical System, Da Vinci systems, and ARTAS. Robotic-assisted approaches improved precision, aesthetic outcomes, flap survival, and patient satisfaction, particularly in procedures involving lymphaticovenous anastomosis and nipple-sparing mastectomy. However, challenges included steep learning curves, longer operative times, high equipment costs, and the lack of haptic feedback. Quality assessment rated all studies as moderate. <b>Conclusions</b>: Robotic-assisted surgery demonstrates considerable potential in enhancing plastic and reconstructive outcomes. As systems become more compact, cost-effective, and integrated with AI and biomimetic technologies, their broader adoption is anticipated. Further high-quality studies are needed to optimize these systems and support widespread clinical implementation.
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spelling doaj-art-29d0ed68f5b7492cbbfcd336767470f42025-08-20T02:33:51ZengMDPI AGSensors1424-82202025-05-012510323810.3390/s25103238Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic ReviewIshith Seth0Kaiyang Lim1Edmond Chang2Warren M. Rozen3Sally Kiu-Huen Ng4Department of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, VIC 3084, AustraliaDepartment of Plastic and Reconstructive Surgery, Peninsula Health, Frankston, VIC 3199, AustraliaDepartment of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, VIC 3084, AustraliaFaculty of Medicine and Surgery, Peninsula Clinical School, Monash University, Frankston, VIC 3199, AustraliaDepartment of Plastic and Reconstructive Surgery, Austin Health, Heidelberg, VIC 3084, Australia<b>Background</b>: Robotic surgical systems offer enhanced precision, motion scaling, tremor filtration, and visualization, making them highly suitable for the complex anatomical demands of plastic and reconstructive surgery. While widely implemented in other specialties, their integration in plastic surgery remains limited. This systematic review evaluates the clinical applications, outcomes, and limitations of robotic-assisted techniques in plastic and reconstructive procedures. <b>Methods</b>: Following PRISMA guidelines, a systematic search was conducted across PubMed, Embase, Scopus, and Web of Science for studies published between January 1980 and March 2025. Clinical studies reporting robotic applications in plastic surgery were included, while cadaveric, animal, and non-English studies were excluded. Data extraction and quality assessment were performed using Covidence and validated tools including the CARE checklist, NOS, GRADE, and SYRCLE. A total of 1428 studies were screened, and 31 met the inclusion criteria. <b>Results</b>: Robotic systems were primarily applied in microsurgery (<i>n = 16</i>), breast reconstruction (<i>n = 8</i>), and craniofacial/aesthetic surgery (<i>n = 7</i>). Common platforms included the Symani Surgical System, Da Vinci systems, and ARTAS. Robotic-assisted approaches improved precision, aesthetic outcomes, flap survival, and patient satisfaction, particularly in procedures involving lymphaticovenous anastomosis and nipple-sparing mastectomy. However, challenges included steep learning curves, longer operative times, high equipment costs, and the lack of haptic feedback. Quality assessment rated all studies as moderate. <b>Conclusions</b>: Robotic-assisted surgery demonstrates considerable potential in enhancing plastic and reconstructive outcomes. As systems become more compact, cost-effective, and integrated with AI and biomimetic technologies, their broader adoption is anticipated. Further high-quality studies are needed to optimize these systems and support widespread clinical implementation.https://www.mdpi.com/1424-8220/25/10/3238roboticplastic surgeryreconstructive surgerymicrosurgerysystematic review
spellingShingle Ishith Seth
Kaiyang Lim
Edmond Chang
Warren M. Rozen
Sally Kiu-Huen Ng
Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review
Sensors
robotic
plastic surgery
reconstructive surgery
microsurgery
systematic review
title Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review
title_full Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review
title_fullStr Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review
title_full_unstemmed Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review
title_short Evaluating the Clinical Utility of Robotic Systems in Plastic and Reconstructive Surgery: A Systematic Review
title_sort evaluating the clinical utility of robotic systems in plastic and reconstructive surgery a systematic review
topic robotic
plastic surgery
reconstructive surgery
microsurgery
systematic review
url https://www.mdpi.com/1424-8220/25/10/3238
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