Siddiqui Completes World’s First Robotic Microsurgical Intracranial Brain Surgery

Siddiqui, who is chief executive officer and chief medical officer of the Jacobs Institute, performed indirect bypass, encephaloduroarteriosynagiosis (EDAS) surgery to restore adequate blood supply to the brain in three adults suffering from moyamoya disease (MMD), a rare condition that restricts blood flow through the carotid artery in the skull.

The surgeries took place at Buffalo General Medical Center/Gates Vascular Institute, Kaleida Health’s largest facility and hub for heart, vein and brain care. He sees patients through UB Neurosurgery (UBNS).

The surgeries marked the first cases in a neurosurgical clinical trial sponsored by the Jacobs Institute for the Symani Surgical System developed by the robotics company, Medical Microinstruments, Inc. (MMI).

The investigational cases are part of an Early Feasibility Study approved by the FDA and sponsored by the Jacobs Institute, a nonprofit medical device innovation center that aims to accelerate the development of next-generation technologies in vascular and neurologic medicine.

The study assesses the safety and preliminary effectiveness of Symani in performing robotic-assisted neurosurgery for adult patients with MMD. In general, surgical treatment aims to reduce the occurrence of stroke, seizures, paralysis, and vision problems for patients, including serious and permanent damage to the brain.

“This study represents so much more than foundational work for robotic brain surgery,” Siddiqui said. “The early success of these first brain surface cases, and the ability to perform minute surgical moves on the pulsating brain, should make the world as excited as it makes me and my esteemed peers in the neurosurgery community as we explore more ways Symani can revolutionize brain surgery.”

The Symani Surgical System is designed to provide enhanced precision and control for the anastomosis and suturing of microscopic vessels with the thinnest available sutures. 

The advancement to first-in-human application builds on a 2024 preclinical trial study at the Jacobs Institute which confirmed Symani’s potential in brain surgery, according to Mark Toland, CEO of MMI.

In that study, Siddiqui successfully repaired a blood vessel in the brain in an animal model using the Symani Surgical System.

“Dr. Siddiqui’s cases demonstrate how Symani delivers the precision required for the delicate, highly skilled maneuvers that neurosurgery demands — capabilities that facilitate and potentially even exceed what the human hands alone can achieve,” Toland said. “This milestone represents meaningful progress toward expanding robotic microsurgery into one of the most technically challenging areas of patient care.”

Siddiqui was invited to deliver the Hopkins Lecture at the Congress of Neurological Surgeons annual meeting where he presented these very first cases on Oct. 14 in Los Angeles. 

The lecture honors the late L. Nelson “Nick” Hopkins, MD, founder of the Jacobs Institute and a pioneering figure in neurosurgery, who was a SUNY Distinguished Professor of neurosurgery and who served as department chair from 1989 to 2013 at the Jacobs School.