Robot technology has found a new use: steadying the hands of surgeons and permitting previously impossible operations.
Doctors in the Maastricht University Medical Center in the Netherlands used a new robot for the first time to perform a delicate operation on 10 breast cancer patients. The patients had a condition called lymphedema, which affects about a third of survivors in the first two years following surgery, and were already scheduled for conventional surgery.
The surgeons used a robotic system called MUSA to assist with a procedure to connect lymph vessels to nearby veins. It’s done to alleviate swelling caused by scar tissue that forms when surgeons remove lymph nodes in the armpit to check whether the cancer has spread. The operation bypasses the affected area.
Only a few specialists worldwide can perform the “supermicrosurgery,” which refers to procedures on vessels that range from 0.3 to 0.8 millimeters.
“Supermicrosurgery is limited by the precision and dexterity of the surgeon’s hands,” researchers wrote in a Nature Communications article published Feb. 11. “Robot assistance can help overcome these human limitations, thereby enabling a breakthrough in supermicrosurgery.”
The robotic system is designed to cancel small tremors in the surgeons’ hands and reduce their hand movements. It’s activated by foot pedals, and the surgeon uses joysticks to control the surgical instruments. A one-centimeter movement of the joystick by the surgeon causes the robot arm to move a tenth of a millimeter.
The doctors compared the patients who underwent the robotic procedure with 10 others who had conventional surgery and found that those who had the robot-assisted procedure healed faster than the others.
Robot technology in medicine isn’t new. The market leader is the Da Vinci system, which can operate with a degree of precision down to 1 millimeter but hasn’t been found to have better results than conventional surgery. Da Vinci also costs a prohibitive $2 million plus maintenance fees.
“We already enhance our eyes with microscopes, but up until now, we still had to do the surgery with our hands,” Tom van Mulken, a consultant plastic surgeon at the hospital in Maastricht, told The Guardian. “The microscopes are getting stronger and stronger, so our eyes are not the problem, but our hands cannot keep up any more.”
- Robotic mastectomy patients have better quality-of-life outcomes than those who have open surgery, according to a recent European study.
- Robot-assisted operations accounted for 15.1% of all general surgeries in 2018, up from 1.8% in 2012, JAMA reported in January. The study highlights the need to monitor the adoption of robot technology doesn’t outpace evidence of its efficacy, the authors said.