PhD Defence Tom J.H. van Mulken

Keywords: Robotic Microsurgery, Dedicated microsurgical robot
 

"Robotic microsurgery in plastic and reconstructive surgery: The journey of creating, introducing and (pre) clinical validation of a new and dedicated robot for microsurgery"

This thesis describes the journey of creating the world’s first dedicated robot for microsurgery.  

Microsurgery is a form of surgery where microscopes are needed to see the small structures that are operated upon. Examples of microsurgery are operations to reconstruct defects after cancer surgery (transplanting a muscle from the leg to reconstruct a paralysed face, transplanting skin and fat from the abdomen for breast reconstruction). Other examples are the reconstruction of lymphatic flow in breast cancer-related lymphedema or the replantation of traumatically amputated fingers.  

As the human eye is assisted by microscopes, this leaves the human hand as limiting factor in these precise operations. Therefore, a dedicated microsurgical robot was designed by a collaboration of microsurgeons of the Maastricht University Hospital and technical engineers of the Technical University in Eindhoven, The Netherlands. The goal of the new robot is to enhance the precision of the surgeon’s hands by motion scaling and tremor filtration. 

The robot was tested on artificial silicone vessels in the laboratory. A small animal study commenced to validate the robot on living blood vessels. After improving the robot with the first lessons learned, a new phase of clinical studies on patients followed.  From the first idea to an actual working robot, this thesis concerns a period of 17 years of research.  

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