Supermicrosurgery in reconstructive surgery: a comprehensive bibliometric analysis
- 1St John’s College, The University of Cambridge, Cambridge, UK
- 2St Andrew’s Centre for Plastic Surgery & Burns, Broomfield Hospital, Chelmsford, Essex, UK
- 3Department of Plastic and Reconstructive Surgery, The Royal London Hospital, Barts Health NHS Trust, London, UK
Abstract
Background: Supermicrosurgery represents an important advancement within the field of reconstructive surgery. This advancement has enabled anastomosis of vessels ≤0.8 mm and has broadened applications in lymphatic surgery, perforator-based reconstruction and technology-based microsurgery. Clinical applications have advanced substantially, but the evolution of the field has not been comprehensively characterised.
Methods: A bibliometric analysis was conducted to assess the global supermicrosurgery literature. A systematic search of PubMed, Web of Science and the Cochrane Library was performed on 1 April 2026 using the search terms 'supermicrosurgery' OR 'supramicrosurgery'. Publications describing clinical, translational, technical, or imaging-related applications within the field of supermicrosurgery were included. Data extracted comprised publication characteristics, citation metrics, anatomical distribution, technique classification, and Oxford Centre for Evidence-Based Medicine levels of evidence. Descriptive analyses of temporal and thematic trends were undertaken.
Results: A total of 175 studies published between 1998 and 2026 were included, accumulating 3578 citations. Publication output increased after 2013 and reached its highest level between 2023 and 2024. The largest domain was lymphatic applications (58.3%), followed by reconstructive applications (30.3%). The most commonly studied anatomical regions were lower limb and combined extremities. There was a marked growth in technology-enabled supermicrosurgery after 2020 and this included robotic and digitally assisted techniques. Level IV observational studies predominated in the literature, accounting for 54.3% of included studies. Japan was the leading contributor followed by South Korea, Italy, and the United States.
Conclusion: Supermicrosurgery has developed from a specialised reconstructive technique into a broad technical framework with expanding applications in lymphatic surgery and technology-assisted surgery. Despite rapid academic growth, the field remains limited by a predominance of lower-quality evidence, highlighting the need for higher-quality comparative and prospective research.
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BibTeX
@article{gosall2026supermicrosurgery,
title = {{Supermicrosurgery in reconstructive surgery: a comprehensive bibliometric analysis}},
author = {Dilip Gosall and Oluwatobi Adegboye and Michalis Hadjiandreou and Gurjinderpal Singh Pahal and Georgios Pafitanis},
journal = {JPRAS Open},
year = {2026},
month = sep,
doi = {10.1016/j.jpra.2026.09.001},
url = {https://doi.org/10.1016/j.jpra.2026.09.001},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Supermicrosurgery in reconstructive surgery: a comprehensive bibliometric analysis
AU - Dilip Gosall
AU - Oluwatobi Adegboye
AU - Michalis Hadjiandreou
AU - Gurjinderpal Singh Pahal
AU - Georgios Pafitanis
PY - 2026
DA - 2026/09/07
JO - JPRAS Open
DO - 10.1016/j.jpra.2026.09.001
UR - https://doi.org/10.1016/j.jpra.2026.09.001
AB - Background: Supermicrosurgery represents an important advancement within the field of reconstructive surgery. This advancement has enabled anastomosis of vessels ≤0.8 mm and has broadened applications in lymphatic surgery, perforator-based reconstruction and technology-based microsurgery. Clinical applications have advanced substantially, but the evolution of the field has not been comprehensively characterised. Methods: A bibliometric analysis was conducted to assess the global supermicrosurgery literature. A systematic search of PubMed, Web of Science and the Cochrane Library was performed on 1 April 2026 using the search terms 'supermicrosurgery' OR 'supramicrosurgery'. Publications describing clinical, translational, technical, or imaging-related applications within the field of supermicrosurgery were included. Data extracted comprised publication characteristics, citation metrics, anatomical distribution, technique classification, and Oxford Centre for Evidence-Based Medicine levels of evidence. Descriptive analyses of temporal and thematic trends were undertaken. Results: A total of 175 studies published between 1998 and 2026 were included, accumulating 3578 citations. Publication output increased after 2013 and reached its highest level between 2023 and 2024. The largest domain was lymphatic applications (58.3%), followed by reconstructive applications (30.3%). The most commonly studied anatomical regions were lower limb and combined extremities. There was a marked growth in technology-enabled supermicrosurgery after 2020 and this included robotic and digitally assisted techniques. Level IV observational studies predominated in the literature, accounting for 54.3% of included studies. Japan was the leading contributor followed by South Korea, Italy, and the United States. Conclusion: Supermicrosurgery has developed from a specialised reconstructive technique into a broad technical framework with expanding applications in lymphatic surgery and technology-assisted surgery. Despite rapid academic growth, the field remains limited by a predominance of lower-quality evidence, highlighting the need for higher-quality comparative and prospective research.
SN - 2352-5878
ER -