The Application of Orthopedic Surgical Robot-Assisted Technology in Various Clinical Scenarios Involving Bone Tumors.
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OBJECTIVES: Over the past three decades, orthopedic surgical robots have experienced rapid advancements. This study, a case series, aimed to investigate the effectiveness, limitations, and technical improvements associated with the application of robots in the surgical treatment of bone tumors. METHODS: From November 2021 to October 2023, 54 patients with bone tumors who provided consent for robot-assisted surgery were included. Patients were divided into three groups based on specific objectives: robot-assisted path planning, pedicle screw insertion, and intraoperative real-time navigation-assisted tumor resection. Perioperative conditions were meticulously recorded for all patients, including intraoperative blood loss, operation duration, postoperative complications, and tumor diameter. RESULTS: Nineteen patients underwent robot-assisted tissue biopsies, and pathological examinations confirmed a positive rate of 84.21%. Among the 21 patients undergoing robot-assisted pedicle screw placement, surgical planning was executed with high accuracy. Twenty patients undergoing robot-assisted lesion excision achieved precise resection of the tumor-affected bone segments as planned preoperatively, and no secondary osteotomies were required. No perioperative complications related to the use of robots were observed in the 54 patients. To address the limitation of orthopedic robots in differentiating soft tissues, we integrated ultrasound technology and the da Vinci robot. Additionally, patient-specific cutting guides were utilized to compensate for the prolonged operation time associated with planar planning using orthopedic robots. CONCLUSIONS: Robot-assisted technology facilitates the precise planning of the surgical path and determination of the osteotomy plane. The integration of orthopedic robots with intraoperative ultrasound or Da Vinci robots can potentially further ensure the safety of bone tumor surgery while maintaining its accuracy, thereby minimizing the risk of complications associated with surgical procedures. Furthermore, this technology combined with patient-specific cutting guides may be conducive to reducing operation time.