High-Precision Robotic Assistant Facilitates Microsurgery

A novel robotic system stabilizes and scales down a surgeon’s movements during complex microsurgical procedures on the sub-millimeter scale.

The Microsure (Eindhoven, The Netherlands) MUSA is a dedicated microsurgical robot designed to assist surgeons during complex procedures on small tissue structures, for example in lymphatico-venous anastomosis (LVA), used to treat chronic lymphedema in breast cancer survivors. The system miniaturizes the surgeons hand movements and reduces any shaking so that they can work on small anatomies. It can work with most existing surgical tools and microscopes, and thus integrates into the existing operating room (OR) workflow and infrastructure.

The system virtually eliminates factors that affect human precision, such as physiological tremor, poor accessibility, or fatigue. As a result, when using MUSA, surgeons can perform anastomosis in extremely small vessels. In a recent study by clinicians at Maastricht University Medical Center (MUMC; The Netherlands), MUSA was used to successfully perform LVA on twenty women, which involved operating on vessels as small as 0.3 mm in diameter, The supermicrosurgical procedures too half the time and resulted in superior outcomes. The study was published in the November 2019 issue of Nature Communications.

“Supermicrosurgery is limited by the precision and dexterity of the surgeon’s hands. Robot assistance can help overcome these human limitations, thereby enabling a breakthrough in supermicrosurgery,” concluded lead author Tom Van Mulken, MD, and colleagues. “Furthermore, a steep decline in duration of time required to complete the anastomosis is observed in the robot-assisted group… indicating promising results for the future of reconstructive supermicrosurgery.”

Chronic lymphedema is common in breast cancer patients who have been treated with a combination of surgery, chemotherapy, and radiation, but it can also occur in all full lymph node dissections. If too many lymph fluid channels are removed, the fluid downstream becomes trapped, leading to lymphedema. Till now, it has been managed with a combination of physical therapy and compression bandaging, but once the condition occurs it cannot be eliminated entirely without microsurgical techniques.

Related Links:
Microsure
Maastricht University Medical Center