a, b Setup of the robot in a laboratory setting. In general the system is composed of the following: (1) master manipulators that are forceps-like joysticks, mounted to the operating table. These master manipulators are controlled by the operating surgeon. (2) A suspension ring that is attached to the operating table. The ring is placed between the operating field and the surgical microscope. (3) Slave manipulators that are robotic arms, which are attached to the suspension ring. The robotic arms can be equipped with genuine (super)microsurgical instruments. (4) Foot pedals that activate the system. A digital interface converts the movements of the master manipulators onto movements of the robotic arms. Motion scaling and tremor filtration can be adjusted by the software and controlled by foot pedals. c The MUSA in a clinical setting (the authors have preoperatively obtained patient’s consent to publication of the image). The microsurgeon on the left controls the MUSA via two master manipulators, which are mounted to the operating table. Two slave manipulators, mounted to the suspension ring between the operating field and the surgical microscope, then mimic the surgeon’s hand movement. In this case the microsurgeon on the right provides manual assistance during the procedure in an identical way as would be in conventional microsurgery cases with two surgeons.