MMI (Medical Microinstruments)

Scores by criterion

Each criterion is defined on our methodology page.

Who uses MMI and what it's for

Symani is used by plastic and reconstructive surgeons for free-flap reconstruction after cancer or trauma, lymphatic surgery for lymphedema, and, in Europe and Asia Pacific, peripheral nerve repair. About 3,500 microsurgical procedures had been done with it by October 2026.⁴

Its buyers are academic and innovation-driven hospitals building robotic microsurgery programs. MMI is also running REMIND, a study of lymphatic surgery in the neck for people with Alzheimer's disease, which the FDA allowed to expand to 15 patients.^4,6

History

MMI was founded in 2015 near Pisa, Italy, by Giuseppe Prisco, Massimiliano Simi, and Hannah Teichmann. It raised a $2 million seed round in 2016, a $24 million Series A led by Andera Partners in 2018, about $75 million in 2022 led by Deerfield Management and RA Capital, a $12 million extension, and $110 million in 2024 in a round led by Fidelity Management & Research Company.^3,5,9

Symani received a CE mark in 2019 and was first used on patients in Florence in 2020. Mark Toland, the former chief executive of Corindus Vascular Robotics, became CEO in January 2021, and the company moved its corporate home to the US in 2022. The FDA granted De Novo authorization in 2024.^8,3

Symani

The system pairs a surgeon console with robot arms holding NanoWrist instruments. Motion scaling of 7 to 20 times and tremor filtering let surgeons work on structures as small as 0.1 millimeters, and the system can be moved between operating rooms.^8,7,6

MMI is adding energy instruments and digital surgery features, and says preclinical work showed a lower thrombosis rate than manual technique.^4,3

Funding

The $125 million Series D, announced on October 8, 2026, was led by existing investor BioStar Capital, with new investors S3 Ventures, Angelini Ventures, and an undisclosed strategic corporate investor. It includes a 17 million euro co-investment from Angelini Ventures and the European Investment Bank announced in September.^4,7

MMI puts total investment to date at about $345 million. BioStar Capital first invested in the 2022 Series B and co-led its extension.⁵

Competitive landscape

Limits

MMI does not publish a price. CNBC reported in 2020 that the full system cost about 900,000 euros, or roughly $1.06 million at the time, and that figure may no longer hold.⁹

The installed base is small. About 50 systems is enough to prove demand at leading hospitals but not yet broad adoption.⁴

Revenue is not disclosed. We estimate it at $20 million to $35 million a year, based on about 50 installed systems at a reported system price near $1 million, plus instruments and service. This is an estimate, not a reported figure.^4,9

What customers say

Where it helps

The first four procedures in Florence included three complex lower-limb reconstructions after trauma and one reconstruction of the pharynx after cancer surgery.⁸

Angelini Ventures notes Symani has been used in trauma, lymphedema, and head, neck, and breast cancer cases.⁷

Where it falls short

We found no independent cost-effectiveness study. Hospitals should ask how instrument costs and longer setup times compare with manual microsurgery under a microscope.⁴

Leadership

• 

  Mark Toland

  Chief executive officer

  Toland became CEO in January 2021 after running Corindus Vascular Robotics, which Siemens Healthineers bought for $1.1 billion in 2019.⁸

  Read full profile

• Massimiliano Simi

  Chief technology officer and co-founder

  Dr. Simi co-founded MMI near Pisa, Italy, in 2015.^2,9

• Caleb Moore

  Chief financial officer

  Moore is MMI's chief financial officer.²

Sources