First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial

Tom J. M. Mulken, Rutger M. Schols (), Andrea M. J. Scharmga, Bjorn Winkens, Raimondo Cau, Ferry B. F. Schoenmakers, Shan S. Qiu and René R. W. J. Hulst
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Tom J. M. Mulken: Maastricht University Medical Center
Rutger M. Schols: Maastricht University Medical Center
Andrea M. J. Scharmga: Maastricht University Medical Center
Bjorn Winkens: Care and Public Health Research Institute (CAPHRI), Maastricht University
Raimondo Cau: Eindhoven University of Technology
Ferry B. F. Schoenmakers: Eindhoven University of Technology
Shan S. Qiu: Maastricht University Medical Center
René R. W. J. Hulst: Maastricht University Medical Center

Nature Communications, 2020, vol. 11, issue 1, 1-7

Abstract: Abstract Advancements in reconstructive microsurgery have evolved into supermicrosurgery; connecting vessels with diameter between 0.3 and 0.8 mm for reconstruction of lymphatic flow and vascularized tissue transplantation. Supermicrosurgery is limited by the precision and dexterity of the surgeon’s hands. Robot assistance can help overcome these human limitations, thereby enabling a breakthrough in supermicrosurgery. We report the first-in-human study of robot-assisted supermicrosurgery using a dedicated microsurgical robotic platform. A prospective randomized pilot study is conducted comparing robot-assisted and manual supermicrosurgical lymphatico-venous anastomosis (LVA) in treating breast cancer-related lymphedema. We evaluate patient outcome at 1 and 3 months post surgery, duration of the surgery, and quality of the anastomosis. At 3 months, patient outcome improves. Furthermore, a steep decline in duration of time required to complete the anastomosis is observed in the robot-assisted group (33–16 min). Here, we report the feasibility of robot-assisted supermicrosurgical anastomosis in LVA, indicating promising results for the future of reconstructive supermicrosurgery.

Date: 2020
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DOI: 10.1038/s41467-019-14188-w

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