Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Apr 22;19(1):253.
doi: 10.1186/s13018-024-04731-x.

Robotic-assisted plate fixation of the anterior acetabulum - clinical description of a new technique

Koroush Kabir  1 , Friedrich-Carl von Rundstedt  2 , Jonas Roos  3 , Martin Gathen  4
Affiliations

Robotic-assisted plate fixation of the anterior acetabulum - clinical description of a new technique

Koroush Kabir et al. J Orthop Surg Res. .

Abstract

Introduction: We present a detailed procedure for the robotic-assisted plate osteosynthesis of an anterior acetabular fracture. The purpose of this work was to describe a robotic-assisted minimally invasive technique as a possible method for reducing complications, pain, and hospitalization. Another goal was to present technical recommendations and to assess potential pitfalls and problems of the new surgical approach.

Methods: Surgery was performed in an interdisciplinary setting by an experienced orthopedic surgeon and a urologist. The DaVinci System with standard instruments was used. Reduction was achieved through indirect traction of a pin that was introduced into the femoral neck and direct manipulation via the plate. The plate position and fixation were achieved through 7 additional minimally invasive incisions.

Results: The technique has multiple advantages, such as no detachment of the rectus abdominal muscle, a small skin incision, and minimal blood loss. Furthermore, this approach might lower the incidence of hernia formation, infection, and postoperative pain.

Discussion: We see the presented technique as a demanding yet progressive and innovative surgical method for treating acetabular fractures with indications for anterior plate fixation.

Trial registration: The study was approved by the local institutional review board (Nr. 248/18).

Keywords: Acetabulum; Minimally invasive approach; Pelvic ring; Plate fixation; Robotic-assisted surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Authors are required to disclose financial or non-financial interests that are directly or indirectly related to the work submitted for publication.

Figures

Fig. 1
Fig. 1
The illustration displays the 3D reconstruction of the fracture morphology based on preoperative CT imaging. The image revealed an anterior column and hemitransverse fracture of the right acetabulum
Fig. 2
Fig. 2
The figure shows the placement of the DaVinci robot in the operating theater during the preparation of the surgical site by the urological surgeon
Fig. 3
Fig. 3
The left image (3a) displays the intraoperative X-ray image without repositioning. The right image (3b) shows the initial repositioning under traction applied by the Steinmann screw
Fig. 4
Fig. 4
Placement of the plate in the operating theater via the suprapubic approach
Fig. 5
Fig. 5
Preoperative X-ray image showing the fracture on the left and postoperative X-ray image showing the correctly positioned implant on the right
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Tosounidis TH, Giannoudis VP, Kanakaris NK, Giannoudis PV. The Ilioinguinal Approach: state of the art. JBJS Essent Surg Techniques. 2018;8(2):e19. doi: 10.2106/JBJS.ST.16.00101. - DOI - PMC - PubMed
    1. Elmadağ M, Güzel Y, Acar MA, Uzer G, Arazi M. The Stoppa approach versus the ilioinguinal approach for anterior acetabular fractures: a case control study assessing blood loss complications and function outcomes. Orthop Traumatology: Surg Res. 2014;100(6):675–80. - PubMed
    1. Wu X, Wang J, Sun X, Zhao C. Guidance for Treatment of Pelvic Acetabular Injuries with Precise minimally invasive internal fixation based on the orthopaedic surgery Robot Positioning System. Orthop Surg. 2019;11(3):341–7. doi: 10.1111/os.12452. - DOI - PMC - PubMed
    1. Kabir K, Welle K, Lingohr P, Jaenisch M, Roos J, Gathen M. APACHE—Anterior plating of the Acetabulum in Hemi-Endoscopic technique: an alternative method for internal fixation of the Acetabulum. Arthrosc Techniques. 2021;10(7):e1815–9. doi: 10.1016/j.eats.2021.03.030. - DOI - PMC - PubMed
    1. Trulson A, Küper M, Trulson I, Minarski C, Grünwald L, Hirt B, et al. Endoscopic Approach to the quadrilateral plate (EAQUAL): a New Endoscopic Approach for plate osteosynthesis of the Pelvic Ring and Acetabulum – a Cadaver Study. Z Orthop Unfall. 2019;157(01):22–8. doi: 10.1055/a-0621-9570. - DOI - PubMed