Breast Cancer Coverage from Every Angle

First-in-Human Clinical Trial of Microsurgery Robot to Treat Breast Cancer–Related Lymphedema

By: Sara Tewksbury
Posted: Thursday, June 25, 2020

Robotic assistance may help surgeons surpass some of their own dexterity limitations when conducting microsurgery and help in connecting lymphatic to blood vessels for the treatment of lymphedema in patients treated for breast cancer. One such robot—called MUSA—is a lightweight device that can be mounted to a surgical table and reportedly integrated easily into an operating room. Tom J.M. van Mulken, MD, of Maastricht University, The Neherlands, and colleagues conducted the study and published their findings in Nature.

“Our data provide the first-in-human proof that robot-assisted supermicrosurgical [lymphaticovenous anastomosis] in patients suffering from [breast cancer–related lymphedema] is in fact feasible and safe using the MUSA,” the investigators concluded.

Twenty female patients were randomly selected to undergo robot-assisted or manual lymphaticovenous anastomosis. A total of 14 anastomoses were completed using robot-assistance, and 26 were completed manually.

The length of the procedure was longer with robotic assistance, with a mean duration of 115 minutes compared with 85 minutes for the manual approach. However, the authors commented that there was a decrease in duration when it was performed by a single microsurgeon, which they attributed to a possible learning curve using the MUSA.

Two patients who received robot-assisted lymphaticovenous anastomosis reported a suspected erysipelas infection, one of whom had previously suffered from in the past. There were no serious adverse events reported with the robotic procedure. After 3 months, patients reported an increase in quality of life and a decrease in arm volume after robotic assistance surgery.

Since the study used a single trained microsurgeon and a small number of patients, the authors indicated that larger multicenter trials are needed to confirm the data and application of using MUSA in supermicrosurgery.

Disclosure: For the study authors’ disclosures, visit

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