Bone Tumor Surgery Robot

Bone Tumor Surgery Robot System

The AI-robot system for endoscopic bone surgery consists of an artificial intelligence surgical navigation system and a bone endoscopic surgical robot system.
Artificial intelligence surgical navigation systems learn ultrasound, MR, and endoscopic image information through deep learning and provide refined information to the medical staff,
The bone endoscopic surgical robot system supports precise and minimal invasive surgery by providing a therapeutic and endoscopic arm, which involves remote controlled and active steering operations possible.

Existing osteocystoma surgery has a large incision and requires a lot of radiographs, which eliminates the risk for the patient and medical staff.

Applying AI based on ultrasound and MR images data will reduce radiation exposure and
minimal invasive surgery by a flexible endoscopic surgical robot, leading to a safe and accurate surgery.

Artificial Intelligence

・Application of ultrasound and MR images,
which were mainly used for soft tissues,
for artificial intelligence learning in musculoskeletal surgery ・Detection of abnormal tissue in endoscopic images that are difficult to identify

: Reducing radiation exposure.
: Accurate skin incision and bone hole creation possible.

Robot technology

・Flexible endoscopic surgical robot with sufficient rigidity and flexibility for musculoskeletal surgery

: Minimally invasive surgery inside
and outside the bone is possible.
: Safe And Accurate Surgery.

System Comparison

Conventional surgery
- Incision site
  
  over 10cm
- Hospitalization period
  
  1 week
- Operation time
  
  3 hours
- Possibility of Infection
  
  High
- Attachment of metal plate
  
  Necessary
- Metal plate removal
  
  Removal surgery after 1-2 years
- Surgical accuracy
  
  Depends on the skill of the surgeon
- C-arm imaging
  
  Average of 30 or more
Robot surgery
- Incision site
  
  about 1cm
- Hospitalization period
  
  3 days
- Operation time
  
  30 minutes
- Possibility of infection
  
  Low
- Attachment of metal plate
  
  Not necessary
- Metal plate removal
  
  No need
- Surgical accuracy
  
  Upward level surgery
- C-arm imaging
  
  Minimum use

Preclinical trials

1. Incision range

The skin incision range was measured in a total of 4 surgeries, and the results are shown in [Table 1].
In the case of
conventional surgeries, the incision range was 13.8 cm. however, the maximum incision range was 3.87cm on average
which decreased by approximately 71% in the case of robotic surgeries.

Results of incision range

(unit : cm)


Case Number	Type of operation	Incision range
T-01	Existing	13.8
T-02	Robot	3.8
T-03	Robot	3.6
T-04	Robot	4.2
Average of Robotic Surgery		3.87±0.25
Average of total surgeries		6.35±4.3

2. Number of C-arm shots

In a total of 4 surgeries, the number of intraoperative C-arm imaging was recorded, and the results are shown in [Table 2].
A total of 16 C-arm images were considered in conventional surgeries, however, an average of 7 times implies a decrease of approximately 56% was considered in robotic surgeries.

Number of C-arm imaging

(Unit: Times)


Case number	Type of surgery	Number of shots
T-01	Existing	16
T-02	Robot	0
T-03	Robot	2
T-04	Robot	19
The average number of imaging for robotic surgery		9.3±8.3
The total average number of imaging		7±8.5

As a result of the incision range test
- Existing surgery
- Robot surgery

- Bone Endoscopic Surgical Robotic System
  <Bone Endoscopic Robotic Arm>
  The bone endoscopic surgical robot system comprised the bone endoscopic robot arm, robot arm manipulator, and end effector. Rigid enough to be used as an end-effector that cuts bones, such as burs or drills. Flexibility to be used in narrow bone space during surgery Channels optimized for use with end-effectors Quick and easy exchange of end-effectors Robot arm base easy to link with the surgical path guide device.
- Bone Endoscopic Surgical Robotic System
  <Robot Arm Controller (BE Controller)>
  A control device that can control two bone endoscope robot arms simultaneously. Intuitive and ergonomic design that does not fatigue even after prolonged use. The manipulating device for controlling the operation of the end effector.
- Bone Endoscopic Surgical Robotic System
  <BE End-Effects>
  Burr, that can transmit rotational power using a bent bone endoscopic robot arm. A flexible endoscope that can enter a bent bone endoscopic robot arm. Saline perfusion device that can provide safe perfusion pressure while cleaning the inside of the bone. The injector of Demineralized Bone Matrix (DBM) Forceps to pick up bone fragments or osteotomy.
- Artificial intelligence surgical navigation system
  The artificial intelligence surgical navigation system comprises artificial intelligence surgery planning and surgical route guidance devices. Detection of bone contours from ultrasound images using artificial intelligence learning The ultrasound image is collected using a surgical route guide device.At this time, the ultrasound image and the position/posture information of the ultrasound probe are simultaneously recorded. 3D Image is reconstructed using this information. Detection of bone contours and lesion locations in MR images using artificial intelligence learning Providing 3D location information of bones and lesions by matching the reconstructed 3D ultrasound image and MR image. Establish a path plan for entering the bone endoscopic robot arm based on the above information. Detecting the presence of abnormal tissue in endoscopic images using artificial intelligence learning
- Route guidance device
  <Standalone Type>
  A route guidance device consists of two manual arms each capable of measuring position/posture with more than 5 degrees of freedom The manual arm can operate Remote of Center (RCM). Locking mechanism to stop the manual arm in the desired position Detachable sleeve for insertion of the bone endoscopic robot arm As the manual arm moves, the insertion position of the bone endoscopic robot arm is transmitted and displayed in real-time on the artificial intelligence surgery planning device. The ultrasonic probe can be detached and the ultrasonic image and probe location information are synchronized.
Surgical procedure
- 01
  Ultrasound scan of bone surface
- 02
  bone surface / 3D reconstruction of MR image
- 03
  Matching ultrasound image and MR image
- 04
  Insertion of bone endoscopic surgical robot
- 05
  Lesion removal using a bone drill
- 06
  Cleaning through perfusion
- 07
  Injection of bone morphogenic inducers
- 08
  Removal of the bone endoscopic surgical robot
- 01
- 02
- 03
- 04
- 05
- 06
- 07
- 08

Bone Tumor Surgery Robot