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Jonis et al. Plast Aesthet Res 2023;10:29 Plastic and
DOI: 10.20517/2347-9264.2023.06
Aesthetic Research

Review Open Access

The MUSA robot and its applicability in lymphatic
surgery

Y. M. J Jonis, Jairo J. A. Profar, Tom J. M. van Mulken, Shanshan Qiu

Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht 6229HX, The
Netherlands.

Correspondence to: Dr. Shanshan Qiu, Department of Plastic, Reconstructive and Hand Surgery, Maastricht University Medical
Center, P. Debeyelaan 25, 6229 HX Maastricht, The Netherlands. E-mail: shanshan.qiushao@mumc.nl

How to cite this article: Jonis YMJ, Profar JJA, van Mulken TJM, Qiu S. The MUSA robot and its applicability in lymphatic
surgery. Plast Aesthet Res 2023;10:29. https://dx.doi.org/10.20517/2347-9264.2023.06

Received: 23 Jan 2023 First Decision: 16 May 2023 Revised: 30 May 2023 Accepted: 9 Jun 2023 Published: 15 Jun 2023
Academic Editors: Nicole Lindenblatt, Xiao Long Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
The development of surgical treatment of lymphedema has been a challenging endeavor. Various surgical
modalities have been proposed, but the results are often unsatisfactory. The lymphaticovenous anastomosis (LVA)
revolutionized by Koshima et al. with the introduction of super microsurgery has gained traction in the treatment of
lymphedema and has shown favorable results. However, super microsurgery requires excellent hand-eye
coordination, meticulous tissue handling, dexterity, and operative flow, which are subject to multiple factors.
Robot-assisted microsurgery (RAMS) has the potential to increase safety for clinicians and patients and create
new possibilities in the field of super microsurgery. Therefore, plastic surgeons of the Maastricht University
Medical Center (Maastricht, the Netherlands) teamed up with engineers from the Eindhoven University of
Technology (Eindhoven, the Netherlands) and developed the first dedicated robotic platform for
(super)microsurgery, the MUSA. The development of MUSA, from inception to the first clinical study in patients
with lymphedema, has yielded promising results. This review aims to elucidate the development of the MUSA and
its role in lymphatic surgery.

Keywords: Lymphatic surgery, super microsurgery, robotic-assisted surgery

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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