A team of experts coordinated by scientists Doctor Maximilian Kückelhaus And Professor Tobias Hirsch of the Center for Musculoskeletal Medicine of the University of Münster performed the first fully robot-supported microsurgery operations on humans. Doctors exploited an innovative operating method in which a new type of operating robot, designed specifically for microsurgery operations, is networked with a robotic microscope.
This new technique allowed the surgeon involved in the surgery to work outside the operating area. The use of robots for clinical research is undertaken in collaboration with the Münster University Hospital and the Hornheide Specialty Clinic.
First microsurgery operations with the support of a robot: the new frontier of surgery?
Experts have been using this technique for two months. To date, five microsurgery operations have been performed successfully, and many more are planned: “This new method of operations allows us to work with a much higher degree of delicacy and precision than is possible with operative techniques. conventional ”, he dit Maximilian Kückelhaus: “As a result, less tissue is destroyed and patients heal faster.”
Specialists use the method, for example, on patients with breast cancer in need of complex breast reconstructions or after accidents where patients require tissue transplants. With the aid of the robot and the robotic microscope, microsurgeons can join the finest anatomical structures such as blood vessels, nerves or lymphatics, which are often only 0.3 millimeters in diameter.
During microsurgery operations, the robot, the so-called Symani Surgical System, adopts the movements of the human hand via an electromagnetic field and joystick. The robot performs the movements of the operating surgeon, reduced in size up to 20 times, using tiny instruments and, in doing so, completely eliminates any tremors present in the surgeon’s hands.
A robotic microscope is connected to the operating robot and this microscope shows the area being operated on via a 3D augmented reality viewer with two high resolution monitors. This headset contains binoculars that can combine the real world with virtual information. In this way, the surgeon’s movements can be recorded and transferred to the robot, making even complicated viewing angles possible on the area involved in microsurgery operations. In addition, the operating surgeon can access a variety of menus and perform functions with the robot without using their hands.
The new technology also has the advantage that operating surgeons can adopt a relaxed posture, while otherwise they have to perform operations in a strenuous posture for a period of several hours: “Since we can now operate on patients remotely, we have much better ergonomics. ”Noted Tobias Hirsch, who holds the chair of plastic surgery at the University of Münster.
“This in turn protects us from fatigue, which means that our concentration can be maintained over a period of many hours. In the first studies of the systems, before they were used in operations, we have already been able to confirm the positive effects on the quality of operations and ergonomics, ”added Dr Hirsch.
During training with established students and microsurgeons, the doctors were able to demonstrate that, while using the robotic system in microsurgery operations, the learning curve, instrument handling and ergonomics demonstrated an improvement over the conventional operating techniques.
In the coming weeks and months, Maximilian Kückelhaus and Tobias Hirsch will perform additional microsurgery operations and, during the surgery, collect data that they will evaluate in scientific studies. Important issues to be addressed are, in particular, the improvement of the quality of microsurgery operations and ergonomics.
“Our hope is that with this new method we can not only perform operations with a greater degree of precision and safety, but also, in the case of smaller structures, go beyond the limits imposed by the human body. Not having to be at the operating table can also mean that one day the operating surgeon will no longer have to be physically present. An expert might be able to perform special operations in any of the different locations, without having to travel and be there in person, ”concluded Maximilian Kückelhaus.
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