A two-system stack combined 3D vision, wristed tools and motion-scaled microsuturing to resect a sarcoma above the larynx.
St Vincent’s Hospital Melbourne used two surgical robots, the da Vinci and the Symani to remove a throat sarcoma while keeping the patient’s larynx. Keeping the larynx avoids a total laryngectomy, which permanently removes the voice box, creates a neck stoma for breathing, and changes how people speak and swallow. These changes require lifelong adaptation and extra clinical support.
The case used two systems with different roles. The da Vinci platform handled the tumour resection inside the throat and after the removal of the tumor, the Symani platform then performed microsurgical repair and reconstruction including suturing vessels around 1–1.5 mm and resuspending the larynx. The hospital reports full removal of the tumour and preserved speech and swallowing in this 27-year-old patient.
Da Vinci is a widely deployed tele-operated system for minimally invasive surgery made by Intuitive Surgical. Symani is a tele-operated microsurgery system made by Medical Microinstruments, designed for work on very small vessels and ducts with motion scaling and tremor reduction. Symani holds a US De Novo authorisation for specified microsurgical indications.
St Vincent’s is the first site in Australia, and in the Asia-Pacific cohort, to introduce Symani. The hospital has set up a Clinical Microsurgery Robotic Unit using the system for breast reconstruction, sarcoma, and head-and-neck reconstruction.
For the sector, the case shows a dual-robot workflow for head-and-neck oncology: a resection robot followed by a microsurgery robot in one session. Dual-robot approaches have been reported in other procedures, such as lymphatic surgery at UZ Brussel. The Melbourne result extends this model to throat cancer, with potential impact on operating room planning, training, and future procurement of complementary robotic platforms.
