A Study to Expand the Use of Symani® Surgical System for Peripheral Nerve Repair

NCT ID: NCT07084207

Last Updated: 2026-02-03

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: NA
• Total Enrollment: 100 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-12-18
• Study Completion Date: 2027-12-18

Brief Summary

The objective of this study is to evaluate the Symani System's safety and effectiveness for microsurgical nerve coaptation, following nerve injuries to the hand.

This study will include participants with traumatic sensory nerve lesions of a finger nerve distal to the carpal tunnel who are treated with nerve suturing.

The primary effectiveness endpoint is the two-point discrimination (2PD) test, at 6-months post index procedure.

The primary safety endpoint is the intraoperative serious adverse event rate.

Conditions

Nerve Injury; Peripheral Nerve Injuries

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: NONE

Study Groups

Robotic-Assisted Surgery (RAS) group

Group Type: ACTIVE_COMPARATOR

Symani® Surgical System

Intervention Type: DEVICE

Robotic-assisted surgery consists of participants who undergo nerve coaptation with the Symani Surgical System, according to the Instruction for Use (IFU). In order for the surgery to be considered a robotic assisted surgery, the participants must be randomized to the RAS group which will include:

• Participants where all nerve coaptations were performed entirely with Symani.
• Participants who underwent a hybrid procedure, where a coaptation was commenced using Symani but a switch to manual suturing occurred during the procedure

Manual Surgery (MS) group

Group Type: ACTIVE_COMPARATOR

Manual Surgery

Intervention Type: PROCEDURE

Manual surgery consists of participants who undergo nerve coaptation through manual techniques by a surgeon using handheld instruments without robotic assistance. In order for the surgery to be considered a manual surgery, the participants must be randomized to the MS group which will include:

• Participants where all nerve coaptations were performed entirely manually.
• Participants who underwent a hybrid procedure, where a coaptation was commenced using manual suturing but a switch to Symani occurred during the procedure.

Interventions

Symani® Surgical System

Robotic-assisted surgery consists of participants who undergo nerve coaptation with the Symani Surgical System, according to the Instruction for Use (IFU). In order for the surgery to be considered a robotic assisted surgery, the participants must be randomized to the RAS group which will include:

• Participants where all nerve coaptations were performed entirely with Symani.
• Participants who underwent a hybrid procedure, where a coaptation was commenced using Symani but a switch to manual suturing occurred during the procedure

Intervention Type: DEVICE

Manual Surgery

Manual surgery consists of participants who undergo nerve coaptation through manual techniques by a surgeon using handheld instruments without robotic assistance. In order for the surgery to be considered a manual surgery, the participants must be randomized to the MS group which will include:

• Participants where all nerve coaptations were performed entirely manually.
• Participants who underwent a hybrid procedure, where a coaptation was commenced using manual suturing but a switch to Symani occurred during the procedure.

Intervention Type: PROCEDURE

Other Intervention Names

RAS; MS

Eligibility Criteria

Inclusion Criteria

1. Adults, at the time of nerve injury aged from 18 to 70 years

2. Patient agrees to participate in the study, returns for all required follow-up visits, and has willingly provided written informed consent after receiving all information related to the study and its requirements

3. Complete loss of a nerve-specific receptive field of the finger

4. Patient with a clinical indication for a microsurgical nerve coaptation in nerve injury that can be repaired by end-to-end suturing

5. Patient with traumatic transection of one or more digit nerves distal to the carpal tunnel with sensory autonomous innervation areas on the finger or thumb tips

6. Investigator considers candidate acceptable for either conventional epineural suturing or robotic-assisted epineural suturing

7. The injury was treated within 10 days

Individuals will be included in the study if the following criteria are met intraoperatively:

Exclusion Criteria

1. Patients who are not capable and/or unwilling to provide informed consent

2. Clinically significant cardiovascular, digestive, respiratory, endocrine, liver 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.

3. Currently enrolled in any other investigational clinical studies that the investigator believes may impact patient safety or outcomes

4. Patients belonging to vulnerable populations, such as pregnant women, or patients ineligible to participate for other reasons in the judgement of the investigator

5. Indication for bilateral nerve repair

6. Known impaired sensibility of the injured finger

7. Patients with implanted pacemaker

8. Replantation which includes bones

Individuals will be excluded from participating in this study if any of the following criteria are met intraoperatively:

1. Any presenting condition discovered intraoperatively that, in the opinion of the investigator, would

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

MMI (Medical Microinstruments, Inc.)

INDUSTRY

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

BG Klinik Ludwigshafen

Ludwigshafen, , Germany

Site Status: RECRUITING

Countries

Germany

Central Contacts

Clinical Operations

Role: CONTACT

clinical.ops@mmimicro.com

8336646276

Facility Contacts

Arne Böcker

Role: primary

Other Identifiers

CDC-00146

Identifier Type: -

Identifier Source: org_study_id