Breast cancer: robotic supermicrosurgery for lymphedema a success in pilot trial

  • van Mulken TJM & al.
  • Nat Commun
  • 11 Feb 2020

  • curated by Pavankumar Kamat
  • Univadis Clinical Summaries
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Takeaway

  • A pilot trial has demonstrated that a robot-assisted, high-precision supermicrosurgery could be safely used for the treatment of breast cancer-related lymphedema.  

Why this matters

  • The new robotic device (MUSA; MicroSure) allows surgeons to connect vessels as small as 0.3-0.8 mm across. 

Study design

  • Women with breast cancer-related lymphedema were randomly assigned to undergo either supermicrosurgery with MUSA (n=8) or manual supermicrosurgery performed by a single surgeon (n=12).
  • 2 microsurgeons blinded to treatment groups assessed the quality of the surgery.
  • Funding: None disclosed.

Key results

  • Upper limb lymphedema at 1 and 3 months after surgery and QoL were comparable between groups.
  • A slightly higher proportion of women in the MUSA vs manual group could discontinue daily use of arm compression sleeves at 3 months (87.5% vs 83.3%).
  • Total surgery time was longer for the MUSA than manual group (mean, 115 vs 81 minutes), but the duration decreased sharply over time for the MUSA group.
    • Decrease suggests a learning curve for using the robot. 
  • No patients reported serious adverse events.

Limitations

  • Small sample size.
  • Patient blinding was not possible because the procedures were performed in conscious patients under local anesthesia.