New surgical robot makes back surgery safer and radiation-free

KU Leuven proposes a new two-armed surgical robot that can place screws in the spine faster, safer and more accurately. The robot works entirely based on ultrasound, eliminating the need for X-rays and complex CT set-ups during surgery. The system is not yet on the market, but represents a promising step towards safer back surgery. The research team received the KUKA Innovation Award for this development.

Low back problems are one of the biggest causes of disability. Patients with severe spinal instability can be helped by a surgical procedure in which screws and rods are placed to strengthen the spine. This procedure requires enormous precision: an error of a few millimetres can lead to serious complications or even paralysis. Currently, doctors operate on patients manually using X-ray or CT images to determine the exact location of their bore. This set-up is complex and in addition, doctor and patient are forced to wear heavy lead suits to protect themselves from the ionising radiation.

Surgical robot

For the first time, the robotic system developed by KU Leuven uses two robotic arms whose movements are coordinated. The first robotic arm takes a 3D image of the spine via ultrasound. The second arm drills automatically and adjusts in real time when the vertebral structure shifts, e.g. due to patient breathing. It is the first robot that notices this and signals it to the second robot.

Medical future

The surgical robot (Ultratopia) could represent a major step forward in the development of medical robots and the treatment of patients with chronic back pain, a problem that affects hundreds of millions of people worldwide and requires surgery for many patients.

Safety and accuracy

"We show that, in consultation with clinicians, certain parts of an intervention can be done with robotic support without sacrificing safety and accuracy. Of course, ease of use is also key. The surgical robot is designed to be easily transportable between different operating theatres. The new system may eventually support doctors in treating patients with low back pain or other problems. With this new robot, an important step has been taken towards a safer, less stressful and more precise approach," said professor of surgical robotics Emmanuel Vander Poorten.

Safe and reliable

The new approach offers striking advantages. First, X-rays with complex set-ups are no longer necessary. Second, automatic drill control increases safety and reliability. Whereas surgeons today have to rely on their own expertise and can only take intermediate scans sporadically, ultrasound can be used continuously and safely. The surgical robot can perform the drilling process very precisely and adjust continuously and instantaneously in case the movement deviates.

Fast recovery

Finally, the combination of ultrasound and robotic compensation enables a minimally invasive approach. Instead of a large incision along the entire back, only small incisions are now needed at the level of where the screws are to be placed. While patients now sometimes have to recover for a long time from large incisions and tissue damage, recovery could be accelerated with the new approach.

KUKA Innovation Award

The project started within a European Horizon 2020 consortium and is now being further developed at KU Leuven. For this, the research group was awarded the KUKA Innovation Award in Düsseldorf, a renowned competition in which more than 50 teams of researchers around the world participated. In this way, they put KU Leuven's surgical robot research in the spotlight enormously.

Source and opening photo: KU Leuven

Read also: Meander Medical Centre buys two da Vinci 5 surgery robots