Robotic surgery in trauma and orthopaedics

Karuppaiah, Karthik; Colegate-Stone, Toby; Dasgupta, Prokar; Tavakkolizadeh, Adel; Sinha, Joydeep

doi:10.1302/0301-620x.97b3.35107

Cited by 80 publications

(70 citation statements)

References 50 publications

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“…19 Overall, there is more evidence now being published in support of robotic surgery, with its usefulness in minimally invasive spinal surgery. 2 Results in the knee arthroplasty have been criticised, with some safety concerns in hip arthroplasty. These have been mainly due to the complications such as blood loss, dislocation, revision rate, heterotopic ossification and significant post-operative functional impairment.…”

Section: Discussionmentioning

confidence: 99%

“…Campaigners of robot-assisted systems boast of better patient outcomes through better pre-operative planning and improved execution of the same. 2 Robotic surgery has been slow in penetrating the surgical practise, due to the huge cost involved, restricted availability, lack of long-term high-impact level 1-research studies regarding their efficiency and the safety of the robots itself. 2 History of robots in medicine: Robot is a machine, which is expected to be able to perform complex tasks automatically.…”

Section: Introductionmentioning

confidence: 99%

“…2 Robotic surgery has been slow in penetrating the surgical practise, due to the huge cost involved, restricted availability, lack of long-term high-impact level 1-research studies regarding their efficiency and the safety of the robots itself. 2 History of robots in medicine: Robot is a machine, which is expected to be able to perform complex tasks automatically. There have been many introduced and installed since the first industrial robot was used in 1961.…”

Section: Introductionmentioning

confidence: 99%

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Role of robotics in trauma and orthopaedics

Janipireddy¹,

Saeed

2017

Int J Res Med Sci

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There is always an ardent desire to obtain the best outcome in any surgery. To improve the quality of life of their patient is amongst the top priorities of most orthopaedic surgeons. It is a big challenge to accurately match a perfect pre-operative planning and obtain that intra operatively. Robotic technology is fast evolving in many surgical branches with orthopaedics as well, but limited with the price tag it comes with. Nevertheless, robotics is gaining momentum with some encouraging short-term results. Robotic surgery can offer significant improvement in surgical planning, accurate implant or prosthetic placement, which provide good outcomes that ultimately enhance patient safety. We review the various robotic advancements in the field of trauma and orthopaedic surgery.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Role of robotics in trauma and orthopaedics

Janipireddy¹,

Saeed

2017

Int J Res Med Sci

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“…5,7,8 Con el objetivo de prevenir este problema, han aparecido la navegación y los sistemas robóticos. 9,10 Específicamente en la cirugía protésica de rodilla esas técnicas han demostrado aumentar la exactitud de los cortes óseos, la precisión del posicionamiento del implante y una mayor protección de los Conclusión Los resultados clínicos postoperatorios tempranos de esta serie de pacientes operados de ATR con asistencia de brazo-robótico, muestran una baja percepción del dolor, con bajo consumo de opioides, una rápida recuperación funcional de la marcha y ROM, y excelentes resultados desde el punto de vista del eje mecánico postoperatorio. Nivel de Evidencia IV.…”

Section: Introductionunclassified

Artroplastía Total de Rodilla con Asistencia de Brazo-Robótico: Resultados Clínicos Postoperatorios Tempranos

Figueroa

Guiloff

Naranjo

et al. 2019

Rev Chil Ortop Traumatol

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Resumen Objetivo Describir los resultados clínicos postoperatorios tempranos de la primera serie de pacientes operados de artroplastía total de rodilla (ATR) con asistencia de brazo-robótico en Latinoamérica. Materiales y Métodos Estudio prospectivo de 52 pacientes (53 rodillas) con gonartoris tricompartimental sintomática operados de ATR primaria con asistencia de brazo-robótico (RIO-MAKO) de manera consecutiva, con seguimiento a 2 meses postoperados. No se excluyeron pacientes. Se utilizó el mismo protocolo anestésico y de rehabilitación. Se realizó revisión de fichas clínicas para recolectar los siguientes resultados: tiempo de isquemia quirúrgica, estadía hospitalaria, tiempo a marcha, dolor postoperatorio diario [Escala visual análoga (EVA)], uso de opioides, rangos de movilidad articular (ROM), pérdida sanguínea, complicaciones y eje mecánico postoperatorio. Resultados Tiempos de Isquemia: 82 minutos (60–120). Estadía Hospitalaria: 4 días (2–12). Dolor postoperatorio: EVA el mismo día operatorio de 0 (0–10) y previa al alta de 0 (rango 0–4), con 0,3 purgas (0–6,5) de opioides por paciente. Tiempo a marcha (día logrado): 1 día (1–3), cuarenta y cinco pacientes (84,9%) iniciaron la marcha el primer día postoperatorio. ROM (Extensión-Flexión): Aumento progresivo durante el seguimiento. En el control ambulatorio de los dos primeros meses [23 días (13–50)], veintiún pacientes (40%) alcanzaron un ROM mayor o igual a 0–90° y once (20%) presentaron un ROM funcional máximo (0–120°). Pérdida sanguínea: Siete pacientes (13,2%) requirieron transfusión. Complicaciones: un paciente (1,89%) presentó una dehiscencia del cierre de la artrotomía. No hubo otras complicaciones. Eje mecánico postoperatorio: 179,1° (178,2–180). Discusión Los resultados concuerdan con la evidencia descrita en otras regiones, sugiriendo que la asistencia de brazo-robótico permite resultados postquirúrgicos reproducibles. Conclusión Los resultados clínicos postoperatorios tempranos de esta serie de pacientes operados de ATR con asistencia de brazo-robótico, muestran una baja percepción del dolor, con bajo consumo de opioides, una rápida recuperación funcional de la marcha y ROM, y excelentes resultados desde el punto de vista del eje mecánico postoperatorio. Nivel de Evidencia IV.

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“…Robot-assisted orthopaedic surgery has proven its ability to improve accuracy and reduce outliers, but the operating time increases due to technical complexity and workflow interruptions (Goradia, 2014) (Karthik, Colegate-Stone, Dasgupta, Tavakkolizadeh, & Sinha, 2015). To integrate robotic technology naturally into the OR with intuitive interfaces and minimal interference to the workflow, we propose a registration assistant utilising a depth camera for registration, while simultaneously avoiding potential obstacles in sight, which shows potential in reducing the registration failure rate, and promises a better coexistence between the surgeon and the robot.…”

Section: Resultsmentioning

confidence: 99%

A Smart Registration Assistant for Joint Replacement: Concept Demonstration

Liu¹,

Bowyer²,

Auvinet³

et al.

EPiC Series in Health Sciences

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In robot-assisted orthopaedic surgery, registration is a key step, which defines the position of the patient in the robot frame so that the preoperative plan can be performed. Current registration methods have their limitations, such as the requirement of immobilising the limb or maintaining the line of sight (LOS). These issues cause inconvenience for the surgeons and interrupt the surgical workflow in the operating room.Targeting these issues, we propose a smart camera-robot registration system for joint replacement. The bone geometry, which is measured directly by a depth camera, is aligned to a preoperatively obtained bone model to calculate the pose of the target. Simultaneously, in order to avoid registration failure caused by LOS disruptions, the depth camera tracks objects that may occlude the target bone, and a robot manipulator is used to move the camera away from the nearest obstacle. An appropriate camera motion to “escape” the obstacle is calculated based on the position and velocity of the obstacle, with the aim of avoiding the occlusion efficiently without changing the general target position in the camera frame. The inverse kinematics of the robot is used to project the Cartesian velocity of the end-effector into the joint space, with kinematic singularities considered for stable robotic control. An admittance controller is designed as the human-robot interface so that the surgeon can directly set the robot configuration by hand according to a given intraoperative scenario.Simulations and experiments with a redundant manipulator were conducted to test the performance of a proof-of-concept implementation. The results show that the proposed obstacle avoidance method can effectively increase the distance between the obstacle and the LOS, which lowers the risk of registration failure due to obstacle occlusion. This pilot study is promising in reducing distractions to the surgeon and could help achieve a fluent and surgeon-centred workflow.

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Robotic surgery in trauma and orthopaedics

Cited by 80 publications

References 50 publications

Role of robotics in trauma and orthopaedics

Role of robotics in trauma and orthopaedics

Artroplastía Total de Rodilla con Asistencia de Brazo-Robótico: Resultados Clínicos Postoperatorios Tempranos

A Smart Registration Assistant for Joint Replacement: Concept Demonstration

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