A new study highlights the benefits of robot-assisted surgery for unstable pelvic fractures.
The integration of Rossum Robot and TiRobot has introduced a fully intelligent and standardised approach to reduction and fixation.
It shows improved precision, safety and patient outcomes compared to traditional methods.
Surgeons have long faced challenges with the complex requirements of pelvic fracture repair, especially in ensuring accurate screw placement after fracture reduction.
These procedures require both surgical expertise and anatomical precision to minimise complications, such as vascular or nerve damage.
This new study demonstrates how the Rossum Robot, equipped with an AI-driven surgical planning algorithm, can complete automatic reduction path planning in under three minutes. The robot uses mirror symmetry of the unaffected pelvis to plan and execute the reduction of the fractured side – especially valuable given the lack of pre-injury 3D CT data in most cases.
Key technologies include:
• Cross-modal image registration integrating pre-op CT with intra-op CBCT
• Optical tracking for real-time dynamic 3D navigation
• Navigation-guided drilling for safe and accurate pin implantation
• The Rossum Robot’s passive holding arm, with nine degrees of freedom and a load capacity up to 24 kg, plays a critical role in stabilising the pelvis during the procedure.
A specialised verification step ensures that reduction only proceeds when image registration accuracy exceeds 80%, enhancing patient safety and reducing intraoperative errors.
The robotic workflow eliminates the need for intraoperative fluoroscopy, reducing radiation exposure for the surgical team.
Although the robot-assisted procedures initially required longer operating times due to the surgical team’s learning curve (averaging 135 min after proficiency), outcomes favoured the robotic group:
• Reduced intraoperative blood loss
• Smaller incision lengths
• Lower complication rate (28% vs. 48%)
• No iatrogenic nerve injuries in the robot group
• Improved reduction quality and screw placement accuracy.
While both groups had similar fracture healing times and hospital stays, the robot group showed better Majeed pelvic function scores, indicating enhanced recovery and quality of life.
Notably, the study found that elderly and osteoporotic patients, as well as those with obesity, benefited equally from robotic surgery, demonstrating its broad applicability and reproducibility across diverse patient populations.
Despite promising results, the Rossum and TiRobot systems currently operate independently, requiring alternating use that affects surgical flow and increases spatial demands in the OR.
The authors propose an integrated robotic system with dual-arm capability for simultaneous reduction and fixation as the future direction for pelvic fracture surgery.
