Nerve Grafts from ‘Bionic Reconstruction’ Could Improve Robotic Surgery

Three male amputees from Austria have successfully received robotic hands as a replacement for their injured hands. These men were the first to have doctors perform bionic hand reconstruction on amputees. They all suffered from accidents which damaged the brachial plexus – the bundle of nerve fibers running from the spine to the hand. Doctors initially tried to repair the nerves, but their hands and arms remained paralyzed.

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The damaged hands were electively amputated and replaced by prosthetic ones. The elective amputation allows surgeons to plan where the incision will be made and how the prosthesis can graft to the bone for stability. The prosthetic hands are controlled by the patients’ mind using muscle and nerve transplants from their legs. Until now, bionic limbs were controlled manually.  

Bionic reconstruction is an operation which involves connecting the nerves directly to the prostheses. The patients first receive cognitive training to equip the brain and body for the attachment of the advanced robotic prosthesis. The advanced robotic prosthesis uses sensors then respond to electrical impulses in the muscles. After the procedure, the robotic hands gave the men control to perform everyday functions using their hands.

"This is the first time we have bionically reconstructed a hand," said Dr. Oskar Aszmann of the Medical University of Vienna, who developed the approach with colleagues. "If I saw these kinds of patients five to seven years ago, I would have just shrugged my shoulders and said, `There's nothing I can do for you.’”

This research is promising for the future of prosthetics. Currently, there are about 2 million people in the U.S. living with an amputated limb.

This new technique also shows promise for the future of robotic surgery. With robotic prostate surgery, nerve grafts can be used to spare sexual function.

Now, researchers have brought together grafts from the muscles and the nerves, which could eventually be used as an extension of robotic surgery.