Some operations require hand movements that are so microscopic that very few doctors are able to perform them. Microsure is currently working on developing MUSA: the world's first surgical robot for open microsurgery. Using two joysticks, the robot converts the surgeon’s hand movements into microscopic movements, making it possible to work with extreme precision. This will make it possible to help more patients in the future. TMC was flown in to optimise the robot on a technical level, a project which is still in full swing as we speak. We asked Erik Niels Boerma (Employeneur at TMC) and Dick Dijkkamp (CTO at Microsure) all about this extraordinary ‘operation’.

Microsure and MUSA

Microsure is a company that specialises in medical devices, based in Eindhoven in the Netherlands and founded by Eindhoven University of Technology and Maastricht University Medical Centre. Dick: “Our focus is on improving the quality of life of patients by developing robotic systems for use in microsurgery. MUSA was designed in close cooperation with microsurgeons and engineers. While the (stereo) microscope helps microsurgeons see better, MUSA will help them better manoeuvre the needle and thread. Thanks to this robot, operations can be performed faster and the human limitations caused by tremors (vibrations) will be completely eliminated.

MUSA does not replace surgeons, but acts as a tool for them to use while operating on structures that are sometimes smaller than half a millimetre in diameter. One well-known operation that we can perform using the robot is lymphatic venous anastomosis, a microsurgical procedure that involves connecting multiple lymph vessels to a small nearby vein. Lymphatic drainage makes weekly massaging unnecessary for patients who have had to undergo a (breast) amputation. There are also advantages for surgeons – avoiding long periods of having to stand in an unnatural position helps prevent back and neck issues. There are two Employeneurs working on MUSA from TMC. One of them is Erik Niels.”

A fresh perspective

“Microsure was looking for support on a mechanical level – fresh blood and a fresh perspective,” explains Erik Niels. “After conducting a comprehensive technical analysis, I saw room for improvement when it came to the usability of the end effector. The end effector is the end of the robot arm, the part that simulates the surgeon’s hand and holds the instruments, also known as the ‘gripper’. I came up with a solution that is compatible with current operating techniques, instruments and other OR equipment. At the moment I am working on its further implementation. I dream of the robot being used worldwide as a mainstream tool in reconstructive plastic surgeries.”

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Added value

What added value does Erik Niels from TMC bring to a project at a start-up like Microsure? “The people that Microsure employs are mainly specialised in software or have clinical expertise,” states Erik Niels. “Microsure has already offered me a job several times, but I can offer them more if I’m not ‘tied’ to them. Because as a part of TMC, I stay with a company for an average of one year. I am always learning new things that I can contribute. This means that my added value for Microsure as a part of TMC is greater than if I were a permanent employee.” Dick adds: “The major advantage for a start-up is that TMC sends people who are versatile and who are also proactive in thinking about the business proposition that they are working on, instead of just focusing on their own specialisation.”

Original solutions

“I am very happy with the collaboration with Erik Niels,” says Dick. “His input is extremely promising and his mechanical design skills are top-notch. Erik Niels is highly inventive and he thinks of fresh ideas and original solutions that we could never have come up with ourselves. He is very enterprising and is able to shift gears as soon as there is another work issue that needs attention.”

A childhood dream

“This is my first project with robots; a childhood dream come true,” reveals Erik Niels. “I love robotics and projects that mean something for humanity or the environment. What I’m creating doesn’t exist yet, which does make it a challenge. But what I enjoy most is that Microsure gives me all the freedom I need, as long as they see progress. That means I can draw on all my knowledge and experience and apply it in ways that were never possible before. All the machines I’ve contributed to so far have been a learning experience for me, allowing me to do what I do today. In developing MUSA, I feel that I can truly give something back and that is to help improve a lot of people’s quality of life.”