Surgical robot achieves milestone on sub-millimetre vessels

A Dutch team claims to have achieved the world’s first super-microscopic surgery with surgical robot hands, in an operation on the lymphatic system.

One of the strengths of a surgical robot is that, by scaling down the movements of a surgeon’s hands on their controls, they allow greater precision than can often be achieved by conventional manual surgery. The Dutch team, at Maastricht UMC+ (University Medical Centre), was using robots developed by Microsure – a spin-off from the medical centre and Eindhoven University of Technology – to perform the procedure to surgically treat a condition called lymphoedema.

surgical robot
The Microsure robot in use at Maastricht UMC+

Lymphoedema is a common side effect of breast cancer treatment. It occurs when the lymphatic system – part of the body’s processes for dealing with waste products in the bloodstream – becomes compromised and allows fluids to build up where they should not. This is potentially serious, as it can be painful and lead to infection. The super microsurgery is a new and promising treatment for this condition, involving the connection of lymphatic vessels to blood vessels to give the fluid another route through which it can drain. But because the vessels involved are so small, the operation is difficult and stressful and only a few surgeons in the world are capable of carrying it out.

The Microsure surgical robot was used by Shan Shan Qiu Shoa, a plastic surgeon at Maastricht UMC+, to suture vessels of 0.3 to 0.8mm in diameter in a patient’s arm. According to Microsure, as well as scaling down Shan’s movements, it also filtered out tremors.

“Microsure enables us to be very precise in our movements during procedures that need a surgical microscope,” Shan said. “Their robot allows us to operate on minuscule lymph vessels and blood vessels with more ease, while getting better results for these complex and fatiguing interventions. Besides, it is very convenient that, within microsurgery, we can operate on vessels of every size with this robot. Most importantly, of course, this is good news for the patients concerned.”

The team announced their achievement at a recent conference on lymphology in Barcelona.

Microsure technical director Raimondo Cau claimed that the operation represented a “key breakthrough” in improving surgery. “As a next step, we aim to assist surgeons during other types of complex microsurgical procedures like tissue reconstructions after removal of a tumour. Using our device they will be able to perform surgery with better precision and fewer complications,” he said.

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