Robotic Assisted Fracture Surgery

  • Payam Tarassoli

Student thesis: Doctoral ThesisDoctor of Medicine (MD)

Abstract

Robotic surgery is a rapidly advancing field which has been improving outcomes from surgical procedures for over 20 years. Within the discipline of orthopaedics, several robotic systems exist which have been used commercially for elective surgery. There is, however, no commercially available robotic system for fracture surgery. This thesis will detail several facets of work relating to robotic fracture surgery.
Clinical studies were carried out to define operating parameters for a fracture reduction robot, to facilitate more precise and appropriate design and construction. These involved measurements of forces required to reduce extracapsular hip fractures with a traction table and in open reduction of lower limb fractures.
Thereafter laboratory studies were carried out to test the usability and performance of the robot in a cadaveric model. The robot was able to reduce the fracture fragments to within clinically acceptable positions in 7 of 9 cadavers tested.
Interviews with patients on robotics and with regards to the RAFS system showed a lack of previous knowledge, but with hesitations and concerns in the patients alleviated with a demonstration of the system. The patients were optimistic regarding the technology and showed a higher than expected willingness to participate in potential research. Interviews with surgeons revealed that many expressed concerns regarding the capability and utility of the device in its current form, but expressed interest in the development of the system and were optimistic about the potential benefits it would confer in the future.
Finally a study of three interfaces for manipulation of a 3D fracture model in a virtual environment demonstrated a superiority of the Xbox and Leap Motion controllers over the mouse and keyboard with regards to time to reduction and reduction accuracy. There was no significant difference between the Xbox and Leap Motion controllers on these parameters.
Date of Award7 May 2019
Original languageEnglish
Awarding Institution
  • The University of Bristol
SupervisorMichael R Whitehouse (Supervisor) & Andrew J Moore (Supervisor)

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