Robots and Tools for Remodeling Bone

Abstract

The field of robotic surgery has progressed from small teams of researchers repurposing industrial robots, to a competitive and highly innovative subsection of the medical device industry. Surgical robots allow surgeons to perform tasks with greater ease, accuracy, or safety, and fall under one of four levels of autonomy; active, semi-active, passive, and remote manipulator. The increased accuracy afforded by surgical robots has allowed for cementless hip arthroplasty, improved postoperative alignment following knee arthroplasty, and reduced duration of intraoperative fluoroscopy among other benefits. Cutting of bone has historically used tools such as hand saws and drills, with other elaborate cutting tools now used routinely to remodel bone. Improvements in cutting accuracy and additional options for safety and monitoring during surgery give robotic surgeries some advantages over conventional techniques. This paper aims to provide an overview of current robots and tools with a common target tissue of bone, proposes a new process for defining the level of autonomy for a surgical robot, and examines future directions in robotic surgery.

Robot-assisted implantation of additively manufactured patient-specific orthopaedic implants: evaluation in a sheep model

“…Surgical robotics has seen a significant increase in adoption over the last decade [ 21 ]. In orthopaedics, robots are primarily used to assist with the placement of off-the-shelf implants [ 22 ], and there are limited examples of work completed on the use of robotics for bone tumour excision. Khan et al demonstrated improved accuracy when using a haptic-guided robotic system for planar cuts as compared to manual surgery [ 23 ].…”

Automated elaborate resection planning for bone tumor surgery

“…Various studies have shown that surgical robots are capable of performing intraoperative tasks with a high degree of precision [16][17][18][19], as well as following complex nonplanar and curvilinear paths for approaches that would not be possible to perform accurately or safely freehand. Khan et al evaluated the deviation from a planned multi-planar osteotomy, comparing the accuracy of freehand unassisted sawing against the same cuts performed with robotic assistance.…”

A New Accurate, Simple and Less Radiation Exposure Device for Distal Locking of Femoral Intramedullary Nails

“…In response to this problem, many novel technologies to localize distal locking holes, have been invented, such as electromagnetic navigation technology 4 , computer-aided navigation technology 5 , orthopedic robots 6 and so on. However, these technologies (including traditional freehand technique 7 ) still have some limitations, such as inaccurate positioning, low first success rate, high demand for expensive equipment, long learning curve of surgeons.…”

“…However, these technologies (including traditional freehand technique 7 ) still have some limitations, such as inaccurate positioning, low first success rate, high demand for expensive equipment, long learning curve of surgeons. 6–13 …”

“…However, these technologies (including traditional freehand technique 7 ) still have some limitations, such as inaccurate positioning, low first success rate, high demand for expensive equipment, long learning curve of surgeons. [6][7][8][9][10][11][12][13] Based on the above problems, our team designed a laser guiding navigation device based on G-arm and a matching positioning technique by taking advantage of the characteristics of the accuracy and stability of laser. The device has the advantages of easy installation, accurate positioning, no radiation exposure during operation, and is easy to master.…”