Tampa General and USF Health Surgeon Performs First Fully Robotic Microsurgical Procedure in U.S. Using FDA-Cleared NanoWrist Dissection Instruments

The breakthrough technology enables unprecedented precision for lymphatic bypass surgery, offering new hope for patients with lymphedema.

Tampa, FL (Dec. 11, 2025) — Dr. Nicholas J. Panetta, MD, FACS, with Tampa General Hospital and the USF Health Morsani College of Medicine has achieved a major milestone in robotic microsurgery in the U.S., performing the first fully robotic lymphovenous bypass (LVB) from incision to closure using FDA-cleared NanoWrist Dissection Instruments on the Symani Surgical System. This innovation allows surgeons to perform delicate tissue dissection and vessel preparation with unmatched control, marking a new era in minimally invasive care for patients living with lymphedema.

Lymphedema is swelling from a buildup of lymph fluid in soft tissues, usually in the arms or legs. It is caused by a damaged or blocked lymphatic system that normally drains fluid and fights infection. Lymphedema is often caused by cancer treatments like lymph node removal or surgery, but the condition can also be genetic. Lymphovenous bypass (LVB) is a supermicrosurgery that treats lymphedema by connecting these blocked lymphatic vessels directly to nearby small veins, creating a new drainage route for built-up fluid and offering relief from swelling.

“Robotics will define the future of microsurgery, especially in lymphedema work where sub-millimeter precision is essential. Using these new instruments, I’m proud to have completed the first fully robotic LVB in the U.S.,” said Panetta, chief of the Plastic Surgery Institute at TGH and chair of the USF Health Morsani College of Medicine Department of Plastic Surgery. “These tools are unlocking capabilities that extend beyond the limits of the human hand to support the best possible outcomes for patients.”

The NanoWrist dissection instruments, recently cleared by the U.S. Food & Drug Administration (FDA), are designed for sub-millimeter precision, enabling robotic access to tiny, delicate anatomy such as lymphatic vessels. Combined with Symani’s advanced technology, these tools allow surgeons to complete complex microsurgical procedures, entirely robotically.

Tampa General and the University of South Florida brought the Symani Surgical System to the southeastern U.S. in November 2024. Tampa General was the first hospital in the region to offer this first-of-its kind robotic technology. Benefits include smaller incisions and less invasive procedures, greater precision involving delicate anatomy and ultimately better patient outcomes.  

Photos and video of this first-in-the-U.S. surgery can be found here. Learn more about the full scope of robot-assisted surgery at Tampa General Hospital.