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ROBOTICS Floor Scholten – Freelance writer and translator


Surgeons get help from micro surgical robot


Threading a needle can be a difficult task for many. It is a manoeuvre that requires a good eye and a steady hand as well as concentration, precision and patience: all these attributes are needed by surgeons to properly carry out their work. It certainly applies to micro-surgeons when stitching minuscule veins, capillaries and nerves together. Help is now available with microsurgery robots, developed at Eindhoven University (TU/e) and commissioned by Maastricht UMC+.


The micro surgical robot, (MSR) was developed by mechanical engineer Raimondo Cau, who recently obtained his doctoral degree on this subject. It took four years, under the guidance of Professor Maarten Steinbuch, to build a prototype robot to help reduce the waiting lists for breast reconstructions. More surgeons will be able to perform this, and other, complex operations with the aid of the robot.


On request The request for an automated operation


assistant for reconstructive surgery came from professor René van der Hulst, plastic surgeon at Maastricht University Medical Centre. According to Van der Hulst there is a great


need for robots to assist surgeons during procedures such as breast reconstructions, specifically if performed following the relatively new deep inferior epigastric perforator (DIEP) method – a procedure which uses the patient’s own abdominal skin and fat to reconstruct natural breasts after mastectomy, thereby preserving all the abdominal muscles. Such microsurgical procedures are complex and impose strict time pressures on the surgeon. The complexity lies primarily in the precision required when attaching minuscule blood vessels, nerves and capillaries to new tissue. It takes two micro- surgeons approximately 16 hours to prepare all the vessels and nerves to then attach them to the new location as accurately as possible. In the Netherlands today there are only


a handful of surgeons who can bring this complex operation to a satisfactory conclusion which has resulted in long waiting lists. “More and more women who are eligible


for breast restorative surgery – due to breast cancer for instance – seek refuge abroad. The waiting list for the procedure is long,” said Raimondo Cau. The prototype robot developed by


Raimondo Cau offers surgeons the possibility to stitch blood vessels and nerves with a diameter of just 1mm together and it is five


‘There is a great need for robots to assist surgeons during procedures such as breast reconstructions.’


times more precise than the hands of the best surgeons. It also means that many more surgeons should be able to perform this and other complex procedure with the help of this robot. “Even an older surgeon, whose hands may not be as steady as they once were, should be able to work again with this robot which corrects jitter,” said Cau.


Master-slave architecture The MSR has a master-slave architecture that


consists of two devices – a master and a slave. The surgeon controls the master, while the slave handles the instruments in the patient’s body, precisely following the movements of the surgeon. The design has taken into account current


working methods and infrastructures in an operating room. The robot can, therefore, fit


The MSR. IFHE DIGEST 2015


The robot from below 87


Photos courtesy of Bart van Overbeeke.


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