Best Surgical Robotics for Plastic Surgeons

David Staughton B.Sc.(Hons) CSP CCEO Practice Consultant

Best Surgical Robotics for Plastic Surgeons: Technology, Costs, and Considerations

Best Surgical Robotics for Plastic Surgeons

Robotic-assisted surgery is transforming the field of plastic surgery, offering enhanced precision, minimally invasive techniques, and improved patient outcomes. Several companies are leading the charge in surgical robotics, including Intuitive Surgical, Stryker, Medtronic, Becton Dickinson & Company, Zimmer Biomet Holdings, Smith & Nephew, Globus Medical, and Procept BioRobotics.

This article explores the best surgical robotic systems available to plastic surgeons, including their applications, benefits, costs, and key considerations when integrating them into practice.

 

Leading Robotic Surgical Systems for Plastic Surgery

1. da Vinci Surgical System (Intuitive Surgical)

  • Overview: The da Vinci system is the most widely used robotic surgery platform globally. It provides high-definition 3D visualization, wristed instruments with enhanced dexterity, and minimal hand tremors.
  • Applications in Plastic Surgery:
    • Transoral robotic surgeries for head and neck reconstruction.
    • Robotic-assisted microvascular surgeries.
    • Minimally invasive flap harvests for breast reconstruction.
  • Pros:
    • Exceptional visualization with 3D magnification.
    • High precision for microsurgical procedures.
    • Minimally invasive with quicker recovery times.
  • Cons:
    • High cost (estimated $1.5 – $2.5 million per unit).
    • Requires extensive training and a learning curve for surgeons.
    • Large footprint in the operating room.

2. Symani Surgical System (Medical Microinstruments – MMI)

  • Overview: The first robotic system explicitly designed for microsurgery, offering precise, wristed instruments with seven degrees of freedom.
  • Applications in Plastic Surgery:
    • Microsurgical nerve repair.
    • Lymphatic surgery.
    • Complex reconstructive procedures requiring high precision.
  • Pros:
    • Minimizes human tremors.
    • Enables supermicrosurgery with ultra-precise motion scaling.
  • Cons:
    • Niche application, mainly suited for advanced reconstructive microsurgery.
    • High cost (estimated around $1 million per system).

3. MUSA (Microsure)

  • Overview: A robotic platform designed for supermicrosurgery, offering enhanced precision and stability.
  • Applications in Plastic Surgery:
    • Lymphatic surgery.
    • Complex nerve repair procedures.
  • Pros:
    • Reduces surgical fatigue.
    • High-precision robotic-assisted microsurgery.
  • Cons:
    • Still in limited use compared to other systems.
    • Requires specialized training.

4. Versius Surgical System (CMR Surgical)

  • Overview: A modular, portable robotic-assisted surgical system designed for minimal access surgery.
  • Applications in Plastic Surgery:
    • Body contouring procedures.
    • General aesthetic and reconstructive surgery.
  • Pros:
    • Compact and cost-effective compared to da Vinci.
    • Modular design allows for flexible use.
  • Cons:
    • Newer system with less widespread adoption in plastic surgery.
    • Some limitations in microsurgical applications.

5. Hugo RAS System (Medtronic)

  • Overview: A cost-effective robotic surgery system designed for multi-specialty use, including plastic surgery.
  • Applications in Plastic Surgery:
    • Minimally invasive aesthetic procedures.
    • Scarless surgery techniques.
  • Pros:
    • More affordable than da Vinci (~$1 million).
    • Flexible and easy to integrate.
  • Cons:
    • Still undergoing market adoption.
    • Fewer specialized tools for microsurgery.

6. CORI Surgical System (Smith & Nephew)

  • Overview: Designed primarily for orthopedic procedures, it is finding applications in reconstructive surgery.
  • Applications in Plastic Surgery:
    • Reconstructive surgeries requiring precise bone reshaping.
  • Pros:
    • Smaller size and cost compared to traditional robotic systems.
  • Cons:
    • Limited use in soft-tissue plastic surgery.

7. ROSA Robotic System (Zimmer Biomet)

  • Overview: Initially designed for orthopedic applications but can be used in craniofacial plastic surgery.
  • Applications in Plastic Surgery:
    • Craniofacial reconstructive surgeries.
  • Pros:
    • High precision in bony reconstructions.
  • Cons:
    • Limited soft tissue applications.

8. ExcelsiusGPS (Globus Medical)

  • Overview: A robotic navigation system initially designed for spinal surgery, with growing potential in reconstructive plastic surgery.
  • Applications in Plastic Surgery:
    • Complex reconstructions that require precise alignment.
  • Pros:
    • High accuracy for skeletal procedures.
  • Cons:
    • Not designed for soft tissue surgeries.

Cost Considerations for Surgical Robotics

  • Initial Purchase Costs:
    • da Vinci: $1.5 – $2.5 million.
    • Symani: ~$1 million.
    • Hugo: ~$1 million.
    • Other systems: Typically range from $500,000 to $1.5 million.
  • Ongoing Costs:
    • Maintenance contracts ($100,000+ per year).
    • Instrument replacement ($2,000 – $10,000 per procedure).
    • Training and certification expenses.

Benefits of Robotic Surgery in Plastic Surgery

  • Precision: Advanced robotics enable superhuman precision in microsurgical procedures.
  • Minimally Invasive Surgery (MIS): Reduced scarring, quicker recovery times, and lower complication rates.
  • Enhanced Ergonomics: Surgeons experience less fatigue during long procedures.
  • Patient Benefits: Shorter hospital stays, reduced pain, and improved cosmetic outcomes.

Challenges and Considerations

  • High Initial Investment: Robotics require significant capital expenditure.
  • Training Requirements: Surgeons and staff need specialized training.
  • Limited Insurance Coverage: Some robotic-assisted plastic surgeries may not be fully reimbursed.
  • Surgical Adaptation: Not all procedures are best suited for robotics.

FAQs about Robotic Surgery for Plastic Surgeons

1. Can robotic-assisted surgery be used for purely aesthetic procedures like facelifts or liposuction?

While robotics are commonly used in reconstructive procedures, their application in purely aesthetic plastic surgery (like facelifts or liposuction) is still limited. However, as robotic technology advances, systems with greater precision and minimally invasive capabilities may become viable for delicate facial surgeries or liposuction with improved contouring.

2. Can AI-powered surgical robots operate without human surgeons?

No, current robotic systems are assistive, meaning a human surgeon always controls them. While AI may help guide movements or improve decision-making, full autonomy in surgery is still far from reality due to ethical, regulatory, and safety concerns.

3. Can robotic systems be used for gender affirmation surgeries?

Yes, robotic-assisted techniques have potential applications in complex gender affirmation surgeries, particularly for microsurgical components such as nerve and vascular reconstructions, which could improve sensation and healing outcomes.

4. What happens if a robotic surgery system malfunctions mid-procedure?

Surgeons are always trained to handle system failures. Most hospitals have backup procedures, including reverting to traditional manual surgery if a robot fails during an operation. Some systems also have redundant safety mechanisms to prevent sudden breakdowns.

5. Do robotic surgical systems make mistakes?

Robotic systems do not make independent decisions, but they can magnify a surgeon’s mistake if not used correctly. Errors often stem from user input, improper calibration, or software issues, rather than the robot itself making a mistake.

6. Can robotic systems reduce the cost of plastic surgery for patients?

While the initial investment is high, robotic-assisted procedures can lead to fewer complications, reduced hospital stays, and faster recovery times, which may lower overall costs in the long term.

7. Can robotic surgery be used in remote plastic surgery or telemedicine?

The concept of remote robotic surgery (telesurgery) exists, but it is not yet widely used in plastic surgery. Challenges include latency in network transmission, licensing regulations, and emergency handling if something goes wrong during a remote operation.

8. Is robotic-assisted surgery safer than traditional surgery?

It depends on the procedure. Robotic-assisted surgery can reduce complications and improve precision, but safety ultimately depends on surgeon skill, patient selection, and the type of surgery being performed.

9. Can surgical robots replace plastic surgeons in the future?

No, plastic surgery requires artistic judgment, creativity, and decision-making that robots cannot replicate. Robotics enhance surgical capabilities, but they will never replace the expertise and intuition of a skilled plastic surgeon.

10. Are robotic-assisted procedures covered by health insurance for plastic surgery?

Coverage depends on the country, the procedure, and the insurance provider. Reconstructive procedures like breast reconstruction after mastectomy may be covered, while purely cosmetic robotic-assisted procedures are generally not covered.

11. Why don’t all plastic surgeons use robots yet?

The cost, training requirements, and suitability of procedures are major barriers. While robotics are growing in reconstructive surgery, not all plastic surgery procedures benefit significantly from robotic assistance.

12. Can a single robotic system be used across multiple surgical specialties?

Yes, many systems like the da Vinci Surgical System and Hugo RAS are designed for multi-specialty use, making them valuable investments for hospitals that offer diverse surgical services.

 

Summary

Robotic-assisted surgery is shaping the future of plastic surgery by enhancing precision and patient outcomes. The da Vinci system remains the most well-known, but newer, cost-effective systems such as Hugo and Versius are gaining traction. Microsurgical robots like Symani and MUSA are pushing the boundaries of reconstructive plastic surgery.

While costs and training requirements remain barriers, the long-term benefits in efficiency and patient satisfaction make robotics an attractive investment for plastic surgeons.