Lymphatic reconstruction has become one of the main indication for robotic assistance in plastic surgery and has received increasing attention in recent years showing encouraging results [1, 2]. However, the use of robots in plastic surgery is still in its relative infancy compared to other surgical disciplines. This is partly because for a long time there were no systems specifically developed for microsurgery. The first in-human robotic-assisted microvascular anastomosis was performed in 2006 with the da Vinci robot (Intuitive Surgical Inc.TM, Sunnyvale, USA), which is most commonly used for laparoscopic surgery [3]. In the following years, only a few clinical cases of robotic-assisted microsurgery such as brachial plexus reconstruction and microvascular anastomosis in oropharyngeal reconstruction were reported [4–6]. The da Vinci system presented several challenges, such as the lack of compatible microsurgical instruments and insufficient image magnification, which pushed the development of robotic systems specifically designed for microsurgical applications [7].