25 September 2013
Broken bones could be mended with robot-assisted surgery
A robotic system that could help surgeons put joint fractures
back together using a minimally invasive approach, will be the
first robot-assisted system designed to deal with this
problem.
The system is being developed at Bristol Robotics Laboratory (BRL) in
collaboration with a leading orthopaedic surgeon, a company
specialising in orthopaedic devices and University
Hospitals Bristol NHS Foundation Trusts. Bristol Robotics
Laboratory is a collaboration between UWE Bristol (the University
of the West of England) and the University of Bristol.
The project, led by Dr Sanja Dogramadzi (Reader in Robotics at
BRL), has just received £642k research funding from the National Institute for Health Research (NIHR)
Invention for Innovation (i4i) Programme to
develop this ground breaking device. Dr Dogramadzi is working
with Professor Roger Atkins (Orthopaedic Surgeon at UH Bristol) and
MatOrtho®,a
UK leading medical device company.
Broken bones that involve joints cause considerable disability
and substantial NHS costs. To work properly and avoid painful
arthritis, the pieces of the joint must be put back together
perfectly. Surgeons do this by making a large incision to open up
the area around the joint and see the broken bits. These
wounds cause pain, scarring and infection risk and long hospital
stays. To avoid these problems, minimally invasive surgery (MIS) is
sometimes used, where joint pieces are manipulated indirectly
through tiny wounds. Unfortunately the bone fragments cannot be
reliably put back together so although the immediate recovery is
quicker and infection and scarring are avoided, there is a risk of
a prolonged radiation exposure during surgery and postoperatively
long-term arthritis and disability.
This new project will create a robotic system which will be used
by the surgeon to put the pieces of broken bones back together
without requiring a major incision combining the advantages of open
surgery and MIS.
Speaking about the project Dr Sanja Dogramadzi says, "Through
our previous research, funded by the EPSRC, we developed a prototype of this system,
but we are now moving to the next stage where we aim to develop a
robust system and undertake preclinical testing.
"We will design and refine our prototype devices that can access
fragments using MIS and move each fragment into a perfect position.
We will develop computer software which tells the robots how to
move the fragments using CT scans. This will be tested in the
laboratory and in cadavers. The developed robot-assisted surgical
system will allow earlier surgery; reliable, perfect fragment
re-alignment; less onerous surgery; improved patient outcomes;
faster rehabilitation; reduced hospital stays; earlier return to
work; arthritis avoidance; and significantly reduced NHS
costs.
"This collaboration is all about taking the latest advances in
technology and using them in a real application which will have
direct benefits to patients. By working closely with surgeons
we are able to design a workable system which will function within
the constraints of medicine and meet the needs of patients.
The robots we develop will enhance the work of surgeons, by
carrying out complex tasks suited to robots, while the surgeon is
always in control and makes the decisions essential to the
patient's wellbeing."
Speaking about the collaboration Professor Roger Atkins says,
"Surgeons have highly specialised skills and expertise, but robotic
technology can enhance those skills for the benefit of
patients. Complex joint fractures frequently require a deep
incision and this has consequences for the patient - a system that
allows fracture reduction, (fixing the pieces of broken bone back
together), without the need for open surgery, would have huge
benefits for patients and potential economic
benefits.
"As part of the research we have been talking to patients on how
they view the use of robots as part of surgery, and in the vast
majority of cases, patients expressed positive views on this, if it
will mean better treatment and faster healing. As a surgeon,
I am always looking for ways to improve or develop, particularly in
areas where we can reduce complications and difficulties for the
patients."
The research will last for 3 years starting in September
2013.
To view a video of Dr Sanja Dogramadzi and Professor Roger
Atkins talking about the project, click here.
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