Supermicrosurgery is a relatively new medical technique that focuses on reconnecting vessels with diameters ranging from 0.3 mm to 0.8 mm. One of its primary applications is tackling lymphedema, which commonly occurs following breast cancer treatment and leads to swelling and localized fluid retention. Given the delicate nature of the process, only a small number of surgeons are currently capable of performing these operations.
Microsure is a Dutch startup spun out of Eindhoven University of Technology and Maastricht University Medical Centre, where researchers have been developing a robot to take on the task of supermicrosurgery. Called Musa, the robot is controlled by a surgeon, but translates their hand movements into more precise actions for a set of robotic hands.
The idea is that this can eliminate factors like hand tremors or other subtle human movements, and overall make the procedure safer and more easily controlled. Last September, Musa performed the first ever robotic supermicrosurgery on a human, suturing a set of thin blood vessels in the patient’s arm.
“Microsure allows us to be very precise in our movements during procedures that require a surgical microscope," says Dr Shan Shan Qiu Shao, a plastic surgeon at Maastricht University Medical Centre who performed that first procedure. “The robot allows us to operate on minuscule lymph vessels and blood vessels while getting better results for these complex and exhausting procedures. With the Microsure robot, we can operate on vessels of all sizes, which is extremely handy. This, of course, is great news for patients.”
The team has now built on this initial success in a newly published study involving 20 lymphedema patients, who randomly underwent either traditional supermicrosurgery or one assisted by Musa. The researchers evaluated the outcomes of these procedures one month after surgery and again at three months, finding that the Musa-assisted surgeries led to an improvement in the patient’s quality of life.
While noting that the findings are very promising for the future of supermicrosurgery, the scientists point out that larger multi-center trials involving more patients and surgeons are needed to verify the results.