Microsure

TU/e spin-off Microsure creates a plastic surgery revolution

Stitching blood vessels just a few millimeters in diameter. Microsure, a joint spin-off of TU/e and the Maastricht UMC+, is developing a medical device that enables recovery surgery that is (almost) impossible to do manually. In two years’ time, the device, the first of its kind in the world, will be ready to use in operating rooms.

A very steady hand and a high level of concentration: there is a lot involved in the precise operations to repair blood vessels and nerve tracts, for example. In fact, so much is demanded of a surgeon that only a few specialists in the Netherlands are able to perform these operations on a regular basis, and even then there is a limit to what is possible. Mechanical engineer Raimondo Cau has a solution. He has developed the MSR, a special microsurgery device. ‘The MSR allows surgeons to operate without any vibration and with five times the precision of a manual operation to perform operations that would otherwise be impossible by hand.’

Cau developed the medical device for Professor René van der Hulst, plastic surgeon at the Maastricht University Medical Center (AZM), who came to TU/e with the question of whether someone could help him solve a microsurgery problem. Cau: ‘In reconstructive surgery tissue is removed from one part of the body to repair a function in another part, for example in breast reconstruction, in children with a congenital defect or victims of serious accidents. The operations required to repair blood vessels and nerve tracts are so precise that only very few surgeons can carry them out. Yet there is a lot of demand for them. The existing Da Vinci robot performs perfectly well for many interventions but is not suitable for these high-precision operations. It’s like pouring water with a crane. Microsurgeons need a small and efficient device that can assist them during very precise operations.’

Challenge

Cau took up the challenge. After observing a lot of operations and talking to microsurgeons, he built a working prototype that is five times as precise as a human hand. ‘The MSR will make the work of a microsurgeon that much easier,’ says Cau. The device is coming on the market at a good time. ‘The need for high-precision recovery operations is increasing fast.’

Reducing movement

The first generation has arrived. Cau explains how the MSR works: ‘The surgeon operates the device via a joystick. The movements are ‘scaled’ to the arms of the MSR. These arms contain the tools that are central to the operation. The surgeon uses a foot pedal to determine the extent to which the human movements must be scaled down and then the MSR filters out the vibrations of the hands, giving the joysticks a reaction if the arms of the MSR touch something (‘force feedback’).’

Having been under the wing of the TU/e spin-off MRT (Medical Robotic Technologies), Microsure has been on its own two feet since March 2016. In January the spin-off acquired a loan of a quarter of a million euros from technology association STW for a business start-up. ‘We really need that money for European CE certification.’ Cau is confident that the MSR will actually be in use within a few years. ‘We are getting so many enthusiastic reactions from the field.’ Van der Hulst also waxes lyrical: ‘The further development of this method could signal a revolution in plastic surgery.’ The first operation robot is expected to be in the operating room in 2018.

Tackling lymphedema and more

Microsure is initially focusing the MSR on tackling lymphedema, a symptom that affects a relatively high number of breast cancer sufferers. Since the lymph system is compromised, the lymphatic fluid may accumulate in the arms and legs, for example. ‘Currently only the symptoms tend to be treated but using the MSR we can repair the natural removal of the lymphatic fluid. In this way, you tackle the cause of the problem,’ says Cau. ‘And there are many more operations that are made possible using this medical device, as in the area of urology, vascular surgery, plastic surgery and neurology.’