A new automated surgical robot guidance system for positioning bone implants during spinal surgery has been demonstrated in vivo. The technology, jointly invented by researchers at the Institute of Intelligent Systems and Robotics and the company SpineGuard, combines a dynamic surgical guidance sensor (DSG)-intelligent drill with robotics. SpineGuard’s DSG consists of a sensor mounted at the tip of surgical instruments that can detect the type of tissue being operated on in real time. In the current version, the sensor produces an audible signal that alerts the surgeon to a bone breach, for example, which can cause complications for the patient. With this new invention, the DSG signal is sent to a robot.
Although surgical guidance technologies already exist, these are far from perfect. For one they are costly and rely on complex robotic navigation platforms. These robots usually only have a 3D model of the area to be operated to go on, and there is no real way of detecting positioning errors as regards to a pre-established operating plan. A patient also has to invariably undergo a scan before the operation, which can not only be stressful but also exposes them to, potentially harmful, X-rays.
Key to the new device’s success is twofold, explains Guillaume Morel, who is director of the Institute for Intelligent Systems and Robotics. First up are its electronics – in particular to ensure data transfer between the dynamic surgical guidance sensor and the robot controller. The real research focus is on the algorithms, however. These allow the robot to adapt its trajectories in real time depending on the signals it receives and to stop it safely in its tracks when needed.
The research team is now busy statistically validating its results and making sure that the location and detection algorithms are robust. The aim of the project is to deploy the technology in new applications, by establishing strategic partnerships with orthopaedic manufacturers who want to integrate DSG into their equipment, says Stéphane Bette, General Manager and co-founder of SpineGuard.
The researchers say they are also considering applying their DSG technology to other surgical procedures and coupling it with an ultrasound imaging system.
For more information: Jimmy Da Silva, Thibault Chandanson and Guillaume Morel, Robot-assisted spine surgery guided by conductivity sensing: first preclinical experiments demonstrate X-ray free breach detection, Hamlyn Symposium on Medical Robotics, June 2019. This paper won 1st prize for the Best Paper Award at the Hamlyn Symposium.