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. 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.

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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

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