The use of a dedicated robot for microsurgery in treating breast cancer-related lymphedema

Women with breast cancer are often treated with (partial) breast and axillary tissue resection and radiotherapy. As survival from cancer continues to improve, greater importance is placed on quality of life after surgery. In about 20% of the women treated for breast cancer, the flow of lymph fluid from the upper extremity to the central venous system is hampered, causing pain and swelling of the arm. Arm lymphedema is an unwanted condition due to its physical and psychological restrictions. The accumulation of lymph fluid can be treated with several options, like manual lymphatic drainage, compression bandaging therapy, or operative reconstruction.  

Microsure has developed a robot that assists in performing the microsurgical lymph vessel reconstruction (LVA procedure). Through motion scaling and tremor reduction provided by the MUSA microsurgical robot, surgeons are able to comfortably suture micro-vessels and reinstall drainage of fluids. After the operative treatment, affected women have less edema and reduced arm dimensions, and in most cases are no longer dependent on manual or bandage decompression for pain relief.1 At some clinics, even prophylactic LVA procedures are considered, as scientific studies have shown that it decreases the incidence of postoperative lymphedema among patients receiving mastectomy with axillary lymph node dissection for breast cancer treatment.2


  1. First-in-human robotic supermicrosurgery using a dedicated microsurgical robot for treating breast cancer-related lymphedema: a randomized pilot trial. TJM van Mulken et al. Nature Communications 2020.
  2. An economic analysis of prophylactic lymphovenous anastomosis among breast cancer patients receiving mastectomy with axillary lymph node dissection. L Squitieri et al. J Surgical Oncology 2020.

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Today’s microsurgical procedures require advanced technology capable of performing complex procedures in simple, intuitive ways. For demanding microsurgical applications MUSA can be used with TIVATO 700, the fully integrated visualization system from ZEISS. It offers effortless use of advanced surgical visualization for advanced microsurgical procedures like lymphatic surgery, free flap surgery, hand surgery, and numerous other procedures.