Bone-mounted miniature robot for surgical procedures: concept and clinical applications

TLDR

The study introduces a bone‑mounted miniature robot for spine and trauma surgery and aims to develop clinical applications for guiding spinal pedicle screws and distal locking screws in intramedullary nailing. The authors designed a semiactive, six‑degree‑of‑freedom parallel manipulator (MARS) that mounts rigidly to bone, enabling precise drill or needle positioning without external tracking and is guided to planned sites using a tool attachment and limited fluoroscopic imaging. Initial in‑vitro tests confirm the feasibility of the bone‑mounted miniature robot concept.

Abstract

This paper presents a new approach to robot-assisted spine and trauma surgery in which a miniature robot is directly mounted on the patient's bony structure near the surgical site. The robot is designed to operate in a semiactive mode to precisely position and orient a drill or a needle in various surgical procedures. Since the robot forms a single rigid body with the anatomy, there is no need for immobilization or motion tracking, which greatly enhances and simplifies the robot's registration to the target anatomy. To demonstrate this concept, we developed the MiniAture Robot for Surgical procedures (MARS), a cylindrical 5/spl times/7 cm/sup 3/, 200-g, six-degree-of-freedom parallel manipulator. We are currently developing two clinical applications to demonstrate the concept: 1) surgical tools guiding for spinal pedicle screws placement; and 2) drill guiding for distal locking screws in intramedullary nailing. In both cases, a tool guide attached to the robot is positioned at a planned location with a few intraoperative fluoroscopic X-ray images. Preliminary in-vitro experiments demonstrate the feasibility of this concept.