Generalization of supermicrosurgery with robotic assistance

Generalization of supermicrosurgery with robotic assistance | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Generalization of supermicrosurgery with robotic assistance Tomohito Okubo, Kazuhito Wakana, Kei Mikami, Shun Otsuka, Ryuta Horie, and 7 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8114833/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 28 Apr, 2026 Read the published version in Scientific Reports → Version 1 posted 9 You are reading this latest preprint version Abstract Supermicrosurgery is an advanced technique that enables the reconstruction and transplantation of tissues by anastomosing blood vessels and nerves 0.3–0.8 mm in diameter using specialized microscopes. This intricate procedure is mastered by only a select few plastic surgeons. However, the potential applications of this technology are widespread, including reconstructive surgery after resection of malignant tumors, organ transplantation, reattachment of amputated digits, and treatment of lymphedema; therefore, more surgeons need to learn such procedures. This study demonstrated that non-plastic surgeons were able to perform supermicrovascular anastomosis in vivo within a short period using a surgical assistant robot. During the robot’s development, emphasis was placed on reducing the difficulty of surgeon’s tasks, utilizing prior experience, enabling intuitive operation, and maintaining concentration. The robot, equipped with a user-friendly interface, was optimized for precise movements and featured advanced motion tracking capabilities and an automatic instrument exchange function. Twelve non-plastic surgeons participated, and after a few hours of training with the robot and practicing vascular anastomosis, they were able to successfully perform an anastomosis of a 0.6-mm rat femoral artery. Robotic assistance will facilitate the widespread adoption of supermicrosurgery. It has the potential to transform surgical practices and benefit more patients in the future. Biological sciences/Cancer Physical sciences/Engineering Health sciences/Health care Health sciences/Medical research Health sciences/Oncology supermicrosurgery robotic assistance vascular anastomosis microsurgical training learning progress automatic instrument exchange Full Text Additional Declarations Competing interest reported. K.W. and other authors affiliated with Sony Group Inc. have submitted a patent application (US17/753,537) related to the structure of a small multi-axis forceps and a patent application (PCT/JP2024/011287) for an automatic instrument-exchange mechanism. These authors declare competing interests. All other authors declare no competing interests. Supplementary Files SupplementaryVideoGuide.docx SupplementaryVideo1.mp4 SupplementaryVideo2.mp4 SupplementaryVideo3.mp4 SupplementaryVideo4.mp4 SupplementaryVideo5.mp4 SupplementaryVideo6.mp4 SupplementaryVideo7.mp4 SupplementaryVideo8.mp4 SupplementaryVIdeo9.mp4 Cite Share Download PDF Status: Published Journal Publication published 28 Apr, 2026 Read the published version in Scientific Reports → Version 1 posted Editorial decision: Revision requested 14 Dec, 2025 Reviews received at journal 05 Dec, 2025 Reviewers agreed at journal 27 Nov, 2025 Reviewers agreed at journal 25 Nov, 2025 Reviewers invited by journal 25 Nov, 2025 Editor assigned by journal 25 Nov, 2025 Editor invited by journal 24 Nov, 2025 Submission checks completed at journal 21 Nov, 2025 First submitted to journal 21 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8114833","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":551827163,"identity":"5f5f3067-86a1-4a02-960b-3fcd5e58b1a1","order_by":0,"name":"Tomohito Okubo","email":"","orcid":"","institution":"Aichi Medical University","correspondingAuthor":false,"prefix":"","firstName":"Tomohito","middleName":"","lastName":"Okubo","suffix":""},{"id":551827165,"identity":"c0654a86-5a3f-4b4d-a0f4-d4b16f0dac84","order_by":1,"name":"Kazuhito Wakana","email":"","orcid":"","institution":"Sony Group 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K.W. and other authors affiliated with Sony Group Inc. have submitted a patent application (US17/753,537) related to the structure of a small multi-axis forceps and a patent application (PCT/JP2024/011287) for an automatic instrument-exchange mechanism. These authors declare competing interests. All other authors declare no competing interests.","formattedTitle":"Generalization of supermicrosurgery with robotic assistance","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"supermicrosurgery, robotic assistance, vascular anastomosis, microsurgical training, learning progress, automatic instrument exchange","lastPublishedDoi":"10.21203/rs.3.rs-8114833/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8114833/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eSupermicrosurgery is an advanced technique that enables the reconstruction and transplantation of tissues by anastomosing blood vessels and nerves 0.3\u0026ndash;0.8 mm in diameter using specialized microscopes. This intricate procedure is mastered by only a select few plastic surgeons. However, the potential applications of this technology are widespread, including reconstructive surgery after resection of malignant tumors, organ transplantation, reattachment of amputated digits, and treatment of lymphedema; therefore, more surgeons need to learn such procedures. This study demonstrated that non-plastic surgeons were able to perform supermicrovascular anastomosis in vivo within a short period using a surgical assistant robot. During the robot\u0026rsquo;s development, emphasis was placed on reducing the difficulty of surgeon\u0026rsquo;s tasks, utilizing prior experience, enabling intuitive operation, and maintaining concentration. The robot, equipped with a user-friendly interface, was optimized for precise movements and featured advanced motion tracking capabilities and an automatic instrument exchange function. Twelve non-plastic surgeons participated, and after a few hours of training with the robot and practicing vascular anastomosis, they were able to successfully perform an anastomosis of a 0.6-mm rat femoral artery. Robotic assistance will facilitate the widespread adoption of supermicrosurgery. It has the potential to transform surgical practices and benefit more patients in the future.\u003c/p\u003e","manuscriptTitle":"Generalization of supermicrosurgery with robotic assistance","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-28 10:51:29","doi":"10.21203/rs.3.rs-8114833/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-12-15T04:12:28+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-05T15:21:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"86726131320605977790640105789256166011","date":"2025-11-27T14:27:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"192217215342037394608065377678393476645","date":"2025-11-25T08:11:45+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-11-25T07:26:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-25T07:21:23+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-11-24T19:17:24+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-21T10:16:52+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-11-21T10:12:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c3867d5a-3948-45aa-b402-253cebcaa001","owner":[],"postedDate":"November 28th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":58723688,"name":"Biological sciences/Cancer"},{"id":58723689,"name":"Physical sciences/Engineering"},{"id":58723690,"name":"Health sciences/Health care"},{"id":58723691,"name":"Health sciences/Medical research"},{"id":58723692,"name":"Health sciences/Oncology"}],"tags":[],"updatedAt":"2026-05-04T17:04:32+00:00","versionOfRecord":{"articleIdentity":"rs-8114833","link":"https://doi.org/10.1038/s41598-026-46648-x","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2026-04-28 15:57:42","publishedOnDateReadable":"April 28th, 2026"},"versionCreatedAt":"2025-11-28 10:51:29","video":"","vorDoi":"10.1038/s41598-026-46648-x","vorDoiUrl":"https://doi.org/10.1038/s41598-026-46648-x","workflowStages":[]},"version":"v1","identity":"rs-8114833","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8114833","identity":"rs-8114833","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}