MMI (Medical Microinstruments Inc.) has earned U.S. Food and Drug Administration (FDA) 510(k) clearance for its NanoWrist scissors and forceps indicated for soft tissue dissection.

The company markets the dissection instruments as the world’s first and smallest fully wristed robotic instruments that are designed for dissection in open microsurgery. The scissors and forceps were designed to preserve tissue integrity and reduce vessel trauma, a level of control that’s critical in procedures like surgical lymphatic repair, perforator-to-perforator reconstruction, and cancer-related head & neck reconstruction.

The clearance expands the Symani surgical system’s role beyond anastomosis to include further critical steps in complex surgeries.

The first U.S. clinical use of the cleared NanoWrist instruments was recently completed at Tampa General Hospital (TGH), which is home to an established microsurgical robotics program. Dr. Nicholas J. Panetta, MD, FACS, chair of the department of plastic surgery at the University of South Florida Morsani College of Medicine and chief of the Plastic Surgery Institute at TGH, specializes in microvascular reconstructive plastic surgery and used the instruments in a lymphovenous bypass (LVB) procedure.

For the surgery, Symani and the NanoWrist instruments were used to complete a specialized microsurgical technique that redirects tiny lymphatic vessels to nearby veins, helping relieve swelling by restoring fluid drainage. Dr. Panetta accessed the surgical site and prepared the lymphatic vessels and veins using the NanoWrist scissors and forceps, then performed the bypass with the NanoWrist SuperMicro needle holder suture cut and SuperMicro dilator.

All the instruments feature seven degrees of freedom, harnessing the benefits of Symani’s motion scaling and tremor reduction features. Dr. Pivetta said he believes that robotics will define microsurgery’s future, especially in lymphedema work where sub-millimeter precision is necessary.

“I have been able to push the limits of microsurgery to treat some of the smallest and most delicate vessels, and the impact Symani is having on our patients has been transformative,” Dr. Panetta told the press. “With robotic enabled dissection, I was able to complete a fully robotic LVB, from incision to closure, with unmatched precision, control and improved ergonomics. These tools are unlocking capabilities that extend beyond the limits of the human hand to support the best possible outcomes for patients.”

These achievements follow a string of milestones for MMI and the microsurgical sector this year, including the company’s advancement into neurosurgery, launching the largest U.S. prospective clinical trial in robotic microsurgery, additional expanded technological and digital surgery capabilities, and gaining reimbursement support for select procedures.

“As we continue to evolve Symani, the first dissection instruments are a critical step in that mission,” said Mark Toland, CEO of MMI. “The addition of these capabilities to our platform is game-changing in supermicrosurgical procedures where extreme precision for the smallest vessels is essential. We will continue to develop technologies that advance the future of microsurgery with Symani and transform microsurgical care and countless lives worldwide.”