A surgeon in Belgium has become the first in the world to perform more than 100 robot-assisted lymphovenous bypass surgeries for patients with lymphoedema.
Professor Dr Alexandru Nistor, a specialist in plastic and reconstructive microsurgery at UZ Brussel, now holds the distinction of being the most experienced robotic lymphedema microsurgeon in the world.
It provides a minimally invasive treatment option for patients experiencing painful limb swelling, often a side effect of cancer treatments such as breast or prostate surgery.
The robotic technique, performed with the Symani Surgical System, offers exceptional precision, resulting in reduced pain, faster recovery, and shorter hospital stays.
The combination of robotic accuracy and highly specialised surgical skill ensures consistent, reproducible outcomes.
The procedure is effective across a wide range of patient groups, including women after breast cancer, men after prostate cancer and those with primary lymphoedema.
Traditional lymphoedema management typically includes compression therapy and manual lymphatic drainage; however, robotic lymphovenous bypass offers a long-term surgical solution.
A single minimally invasive procedure can lead to visible and lasting improvement in symptoms and limb function.
Prof Dr Moustapha Hamdi, head of the Department of Plastic Surgery: ‘The Symani microsurgical robot marks a turning point in the evolution of plastic surgery. With UZ Brussel now leading globally in robotic lymphatic procedures, we are proud to be writing surgical history.’
Lymphoedema remains a highly underestimated condition that can severely impact quality of life. It arises when the lymphatic system is disrupted—often due to surgical removal of lymph nodes during cancer treatment—leading to persistent swelling, discomfort, and reduced mobility.
Prof Dr Alexandru Nistor, coordinator of the Lymph Clinic: ‘Lymphoedema is still too often a taboo subject. Cancer survivors are told to be grateful they’re alive and learn to live with the swollen limb for the rest of their lives. But for many, it’s worse than the cancer they survived, because it stays with them and reminds them daily about their ordeal. Thanks to robotic microsurgery, we can now intervene earlier and improve their quality of life dramatically.
‘Since 2024, we perform most procedures under local anaesthesia. Patients lie comfortably on the operating table, watch the surgery on a TV screen – like a cinema – and we explain what’s happening. We talk, we laugh, and they leave smiling, with visibly less swelling.’
