Maastricht UMC+ is the first hospital in the world to have used 'robot hands' to perform micro-surgery. The honour went to two plastic surgeons who used the device while operating on a breast cancer patient.
The so-called Microsure was developed by TU Eindhoven. The tool was introduced last year but now used in practice for the first time. The two plastic surgeons at the UMC in Maastricht used the telemanipulator to stitch together vessels ranging from 0.3 to 0.8 millimetres during an operation to correct lymphoedema in a breast cancer patient. The patient is doing well and the doctors are satisfied.
Lymphoedema is a chronic condition in which fluid accumulates and causes swelling. It often occurs as a side effect of breast cancer treatment. A relatively new and potentially much better treatment for lymphoedema is supermicrosurgery, in which lymphatic vessels are attached to blood vessels to restore the flow of fluid in the lymphatic vessels to reduce swelling. However, this intervention is difficult because it requires extreme precision and very steady hand of the surgeon. There are only a few surgeons worldwide who can perform this surgical technique by hand.
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The surgeons at Maastricht UMC+ also ran into the limitations of this type of surgery and sought help from TU Eindhoven. 'That is the very best moment,' Maarten Steinbuch, Prof Dr Ir Robotics of TU Eindhoven, said earlier in De Wereld Draait Door. 'That you are presented with a problem and get to come up with a solution to it as an engineer.' The university let student Raimondo Cau use it for his PhD research. 'He first spent twenty operations just looking along, to know exactly what the problem was.'
The solution that Cau eventually came up with and in collaboration with the Maastricht hospital resulted in the spin-off Microsure is a compact robotic arm that can be attached to the microscope. This arm is controlled by a manipulator which in turn is operated by a surgeon. The surgeon makes the same hand movements he would normally make. These movements are transferred to the patient by the robot in a reduced size. A computer sitting between surgeon and robot filters out all vibrations. As a result, even very precise manual interventions are possible.
Other operations
'Microsure allows us to be very precise in our movements during procedures involving a surgical microscope,' said Shan Shan Qiu Shoa, plastic surgeon at Maastricht UMC+. 'The robot allows us to operate on miniscule lymphatics and blood vessels with greater ease, while achieving better results for such complex and exhausting procedures. In addition, when it comes to microsurgery, it is nice that we can operate vessels of any size.' This is because the surgeon's movement can be scaled.
'We are very happy and proud that the first surgery with our robot has been successful,' says Raimondo Cau, the technical brain behind Microsure. 'This proves that our technology is an important breakthrough in improving surgical care. A next step is to assist surgeons during other types of complex microsurgical procedures, such as tissue reconstruction after tumour removal. With the Microsure, it is possible to operate with more precision and fewer complications.'
By: Kelly Bakker
Source + photo: Maastricht UMC+
