Design and Experimental Evaluation of a Novel Robot-Assisted Surgical System for Pelvic Fracture Closed Reduction

Abstract

This paper designs a novel clinical-oriented robot-assisted surgical system (RASS) for pelvic fracture closed reduction, including three core parts: preoperative planning system, intraoperative navigation system and reduction robot. In preoperative planning system, a virtual reduction method based on the Statistical Shape Model (SSM) and pelvic partial surface data is adopted, providing personalized and detailed preoperative plans with high-efficiency and enhanced adaptability. Then, a serial-parallel hybrid reduction robot with robot autonomous and main-secondary reduction mode switching control strategy is designed, combined with the intuitive and real-time guidance of the intraoperative navigation system, achieving flexible and precise reduction operations. Additionally, clinical solution research based on the designed RASS is developed and evaluated by ten pelvic models and five animal experiments. In the pelvic model experiments, the root mean square error (RMSE) of the distance between the reduced and intact pelvic point cloud is 1.0mm, and the three points error of 10 cases are all within 2.0mm, achieving an excellent reduction effect. In the animal experiments, the four point-pairs distance decreases from $26.7\pm 1.04$ mm to $5.86\pm 0.82$ mm, and the mean distance between the two point clouds of the “Pig-081” before modeling and after reduction is 2.81mm, which further confirmed the effectiveness of the system, as well as the feasibility and safety of the clinical solution. The designed novel RASS provides a promising solution in the treatment of pelvic fractures, and the experimental results lay the foundation for further clinical application. Note to Practitioners—RASS is crucial for pelvic fracture closed reduction. However, the clinical application of RASS for pelvic fracture closed reduction still face some challenges, such as the poor adaptability of preoperative virtual reduction, the limited mechanical structure and control strategy of reduction robot, the lack of integration all technical modules of RASS into a unified clinical workflow. To address these challenges, this paper designs a novel clinical-oriented RASS, including a more adaptive preoperative planning system, an intuitive intraoperative navigation system, as well as a flexible and accurate serial-parallel hybrid reduction robot. Based on the designed RASS, a comprehensive solution for RASS-integrated clinical workflow is proposed and evaluated through pelvic model and animal experiments. Experimental results show that our designed RASS can effectively address these challenges and demonstrates excellent reduction effects. The system’s integration design and adaptive workflow also offer insights for advancing robot-assisted solutions in broader orthopedic and trauma surgery applications.