Real-time 3D Navigation-based Semi-Automatic Surgical Robotic System for Pelvic Fracture Reduction

Abstract

Pelvic fracture is a serious high-energy injury with highest disability and mortality rate among all fractures. At present, the reduction of pelvic fracture is still completely dependent on surgeons' experience, which may lead to poor effect of pelvic reduction, thus seriously affecting surgical treatment and postoperative rehabilitation of patients. Based on this, a new robotic system for pelvic fracture reduction was developed and tested. Withdrawing on the optical tracking system, the real-time 3D navigation of pelvic position during operation was realized through Nonrigid ICP method. The target position for fracture reduction was obtained through pelvic symmetry reduction method based on structural symmetry of the pelvis. The shortest reduction path was planned automatically, which could be adjusted by surgeons manually. Finally, the pelvic fracture reduction operation was completed through the robot. System accuracy and effectiveness were demonstrated through laboratory trials and preliminary cadaveric trials. The system resulted in high fracture reduction reliability with the registration accuracy of 1.3749 ± 0.6311mm, and the robot reduction accuracy of 2.8925 ± 0.8647mm. Preliminary cadaveric trials also provided a positive and favorable outcome pointing to the usability of the system in the operating theatre, potentially enhancing the capacity of pelvic fracture surgeries.