A Post-market, Real-world Experience: Expanding Access to Care by Incorporating the Symani® Surgical System and Enabling Surgeons

Exclusion Criteria

• •1. Patients who are incapable and/or unwilling to provide informed consent
• •2. Active systemic infection under treatment with intravenous antibiotics
• •3. Clinically significant cardiovascular, digestive, respiratory, endocrine, or central nervous system disorders, previous mental disorders, or other disorders that may significantly affect the data collection or the ability to comply with the protocol per the investigators discretion
• •4. Known history of significant bleeding, coagulopathy, or Von Willebrand's disease
• •5. Patients with implanted pacemaker
• •6. Planned vein graft
• •7. Currently receiving chemotherapy or radiation therapy
• •8. History of chronic kidney disease
• •9. History of chronic liver disease
• •10. Currently enrolled in any other investigational clinical studies that the investigator believes may impact patient safety or outcomes
• •11. Patients belonging to vulnerable populations, such as pregnant women, or ineligible to participate for other reasons in the judgement of the investigator
• •Free Tissue Transplant Surgery:
• •1. Patients with buried flaps
• •2. Multiple flaps planned for the procedure
• •Lymphovenous Anastomosis Surgery:
• •1. Patients \> 75 years of age
• •2. Patients with prior lymphatic reconstruction surgery
• •3. Patients with venous edema (arising from increased capillary filtration)
• •4. Patients with other medical conditions that could lead to acute limb edema, such as (but not limited to) acute venous thrombosis or heart failure
• •5. Patients with other medical conditions that could result in symptoms which overlap symptoms of lymphedema
• •6. Current infection in the affected limb
• •7. Patients who experience more than one episode of cellulitis in a six month period over the past two years
• •8. Current evidence or a history of malignancy within the past 6 months (if the participant has undergone cancer treatment, this must have been completed \> 6 months prior to enrollment)
• •9. Known iodine sensitivity
• •10. Patient's lymphatic disease is due to lipedema
• •11. Patients with bilateral lymphedema or lymphedema in multiple anatomical locations
• •1. Any presenting condition discovered intraoperatively that, in the opinion of the investigator, would make participating in this study not in the patient's best interest
• •2. The patient does not have at least one robotic stitch attempted during the index procedure