A Survivor's 30-Year Wait for Lymphedema Relief Ends with Hackensack's New Supermicrosurgery Robotic Procedure

For nearly 30 years, Nora Ambros lived with a constant, painful reminder of her first battle with breast cancer. Diagnosed with stage-three cancer in her left breast in 1996, she underwent treatment, including a mastectomy, and later became one of the first patients to have reconstructive surgery at Hackensack Meridian Hackensack University Medical Center. While the treatment saved her life, it left her with a lifelong consequence: severe lymphedema in her left arm.

The chronic swelling seriously impacted her life. She struggled to find clothes that fit, as a larger size would hang off her right side. The physical and emotional burden was immense. She couldn’t push a supermarket cart, and she rarely showed her left arm, which was several sizes larger than her right. Worse, any overexertion or even sitting in the sun could trigger a painful infection, leading to yet another round of antibiotics. For three decades, her only recourse was physical therapy and a tight, uncomfortable compression sleeve.

“It was a constant battle,” Nora recalls. “You survive cancer, and you are so grateful, but then you are left with this daily struggle that affects everything you do. I just learned to live with it, to hide it.”

Nora’s story is a familiar one for thousands of cancer survivors. After treatments like lymph node removal or radiation, many are left with lymphedema—a persistent, painful swelling in an arm or leg. This condition, caused by a blockage in the body’s lymphatic system, affects as many as one in five breast cancer survivors. It's more than just unsightly; it's a heavy burden that can limit mobility, cause discomfort, and often requires wearing tight compression garments for the rest of their lives.

Then, in 2025, Nora’s life took another unexpected turn. A routine screening revealed breast cancer in her right breast. Thankfully, it was caught early. As she prepared for another mastectomy and reconstruction, she received news that would change everything—not just for her new diagnosis, but for the old wound she had carried for so long.

Hope Has a New Home in New Jersey

Hackensack Meridian Hackensack University Medical Center has become the first hospital in the state to acquire and use the Symani® Surgical System, a robotic microsurgery platform. This revolutionary technology is poised to transform the treatment of lymphedema, and for Nora, it was a silver lining she never imagined.

A Microscopic Solution to a Major Problem

Treating lymphedema surgically is one of the most delicate procedures imaginable. It involves rerouting the body’s lymphatic drainage system by connecting tiny lymphatic vessels, with sutures as thin as a human hair, to nearby veins. Think of it as creating a tiny, new detour for the trapped fluid to escape.

This "supermicrosurgery" pushes the boundaries of what the human hand can do. Even the steadiest surgeon is limited by natural hand tremors. This is where the Symani system provides a monumental leap forward. The surgeon, seated at a console, controls the robot’s arms. The system filters out any tremor and scales down the surgeon’s movements, translating them into incredibly precise, steady motions. This allows the surgical team to manipulate and suture these microscopic vessels with a level of accuracy that was once impossible, using sutures that are finer than a strand of silk. Amazingly, Nora’s lymphovenous bypass was performed through several incisions less than 2 inches.

“Lymphedema surgery is the ultimate test of a microsurgeon’s skill. We are working with structures that are barely visible to the naked eye,” explains Richard M. Winters, MD, Chair of Plastic Surgery at Hackensack University Medical Center. “The Symani system gives us unprecedented stability and precision. It allows us to perform these complex lymphatic repairs with a higher degree of confidence and success, offering patients a real chance to reduce their swelling and, in some cases, eliminate the need for lifelong compression garments. It’s truly a paradigm shift in our ability to restore quality of life after cancer and is a tremendous addition to our robust breast reconstruction program.”

A Survivor Becomes a Pioneer

For Nora Ambros, this technology wasn't just a concept; it was a lifeline. While undergoing treatment for her right breast, she was told she was a perfect candidate for the new procedure to finally address the lymphedema in her left arm. She became the very first patient to be treated by Dr. Robert Van using the Symani robot at Hackensack.

The procedure was quick and painless. The next day, she was back to work. Now, just two months later, the difference is profound.

“I can’t even believe it when I look in the mirror,” Nora says, her voice filled with emotion. “My arm is significantly smaller. For the first time in decades, I’m wearing short sleeves and I don’t feel like I have to hide. It’s a freedom I thought I’d never have again.”

She is already looking forward to a life without the constant fear of infection and the daily ritual of pulling on her compression sleeve. “To think that I might not have to worry about getting an infection every time I work in the garden, or that I can go to the store without a second thought… it’s life-changing.”

An Investment in Survivorship

The hospital’s leadership made this major investment with a clear understanding of the profound impact lymphedema has on the community. For patients like Nora, this investment translates directly into a restored quality of life. A successful procedure means more than just a reduction in swelling. It means less pain, a lower risk of infection, and the freedom to live without the constant physical and emotional weight of lymphedema.

“Our commitment to our patients extends far beyond their initial treatment. It’s about helping them live full, healthy lives in survivorship,” said Dr. Winters. “Our community members who have bravely battled cancer now have access to a world-class, life-altering procedure right here at home. At HUMC we are proud to be the home to many fellowship trained microsurgeons with a broad range of subspecialty interests in treating lymphedema and many other complex conditions amenable to microsurgical techniques which are now enhanced by our robotic technology.”

As we celebrate Breast Cancer Awareness Month, Nora is eager to share her story. She wants others who are suffering in silence to know that there is new hope.

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