In a world first, clinicians at Maastricht University have used a robot to perform “supermicrosurgeries”, which involved operating on vessels as small as 0.3 mm in diameter. The procedures were conducted on women with lymphedema, a condition that arose as a result of breast cancer, whose lymphatic vessels were connected to veins to provide a drain for lymphatic fluids that built up.
This is normally very difficult, as working on such tiny vessels requires extremely stable hands. To overcome this, the researchers used the MUSA robot from Microsure, a Dutch firm, that was recently cleared in the EU. The device miniaturizes hand movements and reduces any shaking so that surgeons can work on impressively small anatomy. It works with existing surgical tools and microscopes, and Microsure claims that introducing it into an existing operating room shouldn’t change the workflow or infrastructure of the facility.
The supermicrosurgical lymphatico-venous anastomosis (LVA) procedures were performed on twenty women, who were either operated on using a robot or through manual surgery. The researchers showed that it takes about half as long to perform an anastomosis using a robot and that after three months post surgery, the women treated using the robot had improved outcomes.
Here are some results from the published study in Nature Communications:
In total, 14 anastomoses were completed using robot assistance (n = 8 patients, mean 1.75 ± 0.5, range 1–2) and 26 anastomoses were performed manually (n = 12 patients, mean 2.1 ± 0.7, range 1–4). All completed anastomoses were patent. […] Mean (±SD) duration and range of anastomosis in the robot-assisted group compared with the manual group was significantly different: 25 ± 6 min, range 16–33 min and 9 ± 6 min, range 4–36 min, respectively (p < 0.001). However, a steep decrease in duration of time required to complete the anastomosis was observed in the robot-assisted group (see Supplementary Fig. 1). Mean total time of the full surgical procedure accounted 81 min for the manual group and 115 min for the robot-assisted group.
Mean patients’ convenience during the procedure in the robot-assisted group was 8.0 (±2.0, range 4–10) and 8.6 (±1.1, range 7–10) in the manual group. Surgeons’ satisfaction of the procedure was 3.1 (±0.6, range 2–4) in the robot-assisted group and 3.8 (±0,8, range 2–5) in the manual group.
Open access study in Nature Communications: First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial
Product page: Microsure’s MUSA