Keywords: robotic surgery, image-guided surgery, orthopedics
Summary:We are developing Robossis, an intelligent surgical robotic system for treating long bone fractures, which benefits surgeons by improving alignment by 90%. Robossis consists of a surgical robot, an imaging software, and a haptic controller. Unlike traditional long bone fracture surgeries, Robossis enables the surgeon to accurately apply large traction forces, precisely align the fractured bone, and significantly reduce radiation exposure. The robot has a unique architecture, which facilitates positioning the bone inside the robot, providing a large workspace for surgical maneuvers. Using its imaging technology, Robossis drives the bone fragments into correct alignment and holds them in position for the duration of the surgery. Long bone fractures account for more than half of all fractures. More than 415,000 femur fractures occur in the US annually alone. The target market is high volume hospitals which represent the busiest 25% of them with more than 300 surgeries per year per hospital. US market is $5.2B with a target market of $2.2B. Malalignment is serious complication with long-bone fractures, with a malalignment of 15° or more occurring in 28% of patients. This is the second most common reason that orthopedic surgeons are sued. Malalignment leads to leg-length discrepancies, abnormal gait, and tertiary effects. Patients may require additional surgery—far more invasive than had the first surgery been performed correctly. Robossis alleviates these complications and reduces costs of surgery by decreasing procedure times, repeated operations, and radiation exposure. This benefits patients, surgeons, and hospitals, through improving patients’ outcomes and minimizing the time and money spent on them. A recent cadaver test was performed using a Robossis prototype. Guided by X-rays from a C-Arm, Robossis was able to manipulate bone in all translational and rotational directions while encountering the muscle payload surrounding the femur. We demonstrated that we could successfully manipulate the robot in space, in a controlled way. Robossis was able to insert the needed traction forces to extend the fractured bone segments as well as significantly rotate the bone fragments. Furthermore, these tests showed that Robossis worked well within the configuration of a standard surgical bed as well as a C-Arm machine, and it is compatible with the current operating room setting.