MUSA, the first robot for super microsurgery, developed by researchers at Eindhoven University of Technology and others, has successfully passed its first clinical test. The test took place in collaboration with Maastricht UMC+.
Supermicrosurgery - operations on vessels 0.3 to 0.8 millimetres in diameter - are often challenging due to the vibrations of the surgeon's hand. Robots can help the surgeon during the operation. MUSA is the world's first robot for super microsurgery, co-developed by researchers at Eindhoven University of Technology and TU/e spin-off MicroSure. MUSA was recently used in the world's first clinical trial of robot-assisted super microsurgery, which took place in close collaboration with Maastricht UMC+. The researchers demonstrated that it is safe and feasible to connect lymphatic vessels to blood vessels when treating lymphoedema using the MUSA robot.
MUSA is a compact and lightweight device that can be attached to an operating table, and can be integrated into an operating room without the need to change its set-up. The robot can operate five times more precisely than the human hand. This is possible by converting the surgeon's larger hand movements into the smaller, precise movements of the surgical instruments and filtering out the small, inherent vibrations of the human hand. MUSA was developed in close collaboration between researchers at Eindhoven University of Technology, TU/e spin-off MicroSure, and plastic surgeons at Maastricht UMC+ (MUMC+).
Lymphedema
An example of a treatment where robot-assisted microsurgery can help is the procedure that reduces lymphoedema (fluid accumulation) in the arms. Lymphoedema often occurs after breast cancer treatment when the lymph nodes in the armpit are removed or irradiated. Women who develop lymphoedema after breast cancer treatment often wear arm stockings for life for this reason. In some cases, lymphoedema can be treated with lymphatic anastomosis (LVA) surgery; a procedure in which a connection is made between the lymph vessels and very small blood vessels to drain the excess lymph fluid. The diameters of both vessel types meet the criteria for super microsurgery.
Safe and practicable
Researchers at MUMC+ investigated the safety and feasibility of robot-assisted surgery with MUSA by comparing robot-assisted and manual procedures for the treatment of breast cancer-related lymphoedema. The doctors tested LVA surgery with and without MUSA support in 20 patients. Criteria for evaluating the treatments were the quality and duration of operations, and the score on a lymphoedema questionnaire and a lymphoedema index completed by the patient one and three months after surgery.
The study confirms that it is safe and feasible to connect lymphatic vessels to blood vessels in the treatment of lymphoedema using the MUSA robot. Extensive follow-up studies in multiple centres are needed to further investigate the differences between operations with and without robotic support.
This pilot study is a step in the further development of surgical robots for super microsurgery. This is good news for patients with lymphoedema. In time, more patients can be treated surgically using surgical robots and will no longer need to wear arm stockings after LVA surgeries.
Source: Eindhoven University of Technology.
Photo: Bart van Overbeeke.
