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Robotic knee surgery with the robot system "ROBIN" at a new level | KUKA AG
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Based on the LBR Med from KUKA, the system enables precise robotic-assisted surgery for total knee arthroplasty due to its navigation system.</p> <div class="mod-page-intro__functions hidden-print"> <hr> </div> </div> </div> </section> <article class="mod mod-text" data-ignore="true"> <div class="mod-text__headline"><h2>More precision in knee surgery thanks to "Robin" </h2></div> <div class="copy"><p>The success of an operation often depends on the surgeon's experience and skill – the more complex the procedure, the more important the surgeon. If they work manually, they use mechanical devices, which is time-consuming and potentially error-prone. <strong>With “Robin”, Orthokey is opening the door to advanced computer-assisted orthopedic surgery. </strong>Robin is an <strong>intraoperative robotic system that supports the surgeon</strong> <strong>in planning and positioning orthopedic implants and</strong> <strong>performing precise bony resections.</strong> To do this, it uses the individual patient profile as well as specific kinematic and anatomical characteristics. "We position several trackers on the patient, which can be seen by a camera with an accuracy of less than 1 millimeter. This allows the surgeon to plan the right positioning of the implant for each individual patient before performing a resection," says Simone Bignozzi, Product Manager at <a rel="noopener noreferrer" href="https://www.orthokey.com/" target="_blank">Orthokey</a>, explaining the principle behind “Robin”.</p></div> </article> <section class="mod mod-video skin-video-mp4 hidden-print" itemprop="VideoObject" itemscope itemtype="https://schema.org/VideoObject" > <meta itemprop="name" content="Video" /> <meta itemprop="uploadDate" content="2024-11-06T9:25:41+01:00" /> <meta itemprop="thumbnailUrl" content="https://i.ytimg.com/vi/https://youtu.be/U16uqtYpmLE?si=A__SsbuwOKBYuZy6?rel=0/maxresdefault.jpg" /> <meta itemprop="contentUrl" content="https://www.youtube.com/embed/https://youtu.be/U16uqtYpmLE?si=A__SsbuwOKBYuZy6?rel=0" /> <span class="js-anchorlink" id="Video" data-anchor-title="Video"></span> <div class="row mod-video__row h-pull-row-right-1 h-pull-row-left-1"> <div class="mod-video__col col-12"> <div class="a-video a-video--external"> <a href="/en-se/video?videoid=5b656fd86a3e4559a9334f75c40c7f00" class="a-btn a-btn--primary a-video__link"> <svg width="24" height="24" viewBox="0 0 24 24" fill="none" xmlns="http://www.w3.org/2000/svg"> <path d="M10.95 8.85L3.6 16.2L7.8 20.4L10.95 17.25L12 18.3L7.8 22.5L1.5 16.2L10.95 6.75L15.15 10.95L14.1 12L10.95 8.85Z" fill="white"/> <path d="M16.1999 3.6L13.05 6.75L12 5.7L16.1999 1.5L22.4999 7.8L13.05 17.25L8.84998 13.05L9.89998 12L13.05 15.15L20.3999 7.8L16.1999 3.6Z" fill="white"/> </svg> </a> <div class="a-video__player" > <iframe data-src="https://www.youtube.com/embed/https://youtu.be/U16uqtYpmLE?si=A__SsbuwOKBYuZy6?rel=0" allowfullscreen allowtransparency ></iframe> </div> </div> <div class="mod-video__col col-12 caption-container mod-video__full-width-caption"> <div class="h-margin-top-2"> <span class="caption" itemprop="description" >All the interfaces of the system simplify complex processes for users and make robotic knee surgery more intuitive.</span> </div> </div> </div> </div> </section> <article class="mod mod-text" data-ignore="true"> <span class="js-anchorlink" id="Development" data-anchor-title="Development"></span> <div class="mod-text__headline"><h2>Functionality and experience decide</h2></div> <div class="copy"><p>Dr. Domenico Alesi, orthopedic surgeon at the Istituto Ortopedico Rizzoli in Bologna, praises the ease of use of the system in particular: <b>"’Robin’ is intuitive and visually appealing.</b> All the interfaces simplify complex processes for users and make their work easier." “Robin” is also based <b>on a modular approach that takes into account different implant manufacturers and hospital concepts.</b> Last but not least, Orthokey relies on high-quality components for its operating room solution, including KUKA’s sensitive lightweight robot <a href="/en-se/industries/health-care/kuka-medical-robotics/lbr-med">LBR Med</a>.<br /> <br /> The engineers at Orthokey compared various robots and also considered developing their own. But then the LBR Med from KUKA came into play, which <b>convinced them for three reasons,</b> as Maria Pasquini, CTO of the “Robin” project at Orthokey, says: "Firstly, the <b>robotic arm is already certified for an easy and fast integration into medical devices,</b> which facilitated the certification of the overall system and enabled it to be ready for the market more quickly. The second factor is the <b>seven degrees of freedom and the sensors in each joint, </b>which can increase the robot's accuracy and dexterity in the operating room. And thirdly, <b>the LRB Med is a mature and established solution with reliable software, </b>so we were able to work quickly and effectively right from the start."</p></div> </article> <section class="mod mod-text-image is-image-right" data-ignore="true"> <div class="mod-text-image__headline"><h2>Joint development</h2></div> <div class="row"> <div class="mod-text-image__text col-md-7"> <div class="mod-text-image__copy copy"> <p>From the outset, the idea was <b>to design the system to be simpler and smaller than comparable solutions.</b> Orthokey developed the first prototype <b>in collaboration with the University of Verona.</b> "The proof of concept was ready after eight months, nine months later the development of hardware and software was completed. The first release was ready and documentation was sent to the notified body for product certification," says Bignozzi, describing “Robin's” rocky road to the OR.</p> </div> </div> <figure class="mod-text-image__figure col-md-5"> <picture class="h-ratio h-ratio16-9 h-display-block"> <img alt="" loading=lazy src="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_simple-and-small-solution.jpg?rev=-1&w=1400&hash=3CDDF2FE6E5D4121EE4C442AC3E03166" srcset="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_simple-and-small-solution.jpg?rev=-1&w=767&hash=DF655790BE54551C44956300889B9CF6 767w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_simple-and-small-solution.jpg?rev=-1&w=1400&hash=3CDDF2FE6E5D4121EE4C442AC3E03166 1400w" sizes="(min-width: 768px) calc(93.75vw/5), (max-width: 767px) 90vw" /> </picture> <figcaption class="row h-margin-top-2"> <span class="col-12 caption-container"> <span class="caption">First, the instruments are attached to the robotic system.</span> </span> </figcaption> </figure> </div> </section> <div class="mod mod-text" data-ignore="true"> <div class="copy"><p>Throughout the entire process, <strong>the team worked closely with KUKA's research and development team </strong>and benefited greatly from their experience. "It was clear that KUKA is an extremely well-established robotics company in medical applications and can draw on the knowledge gained from numerous projects. The strong commitment of each individual team member has helped to make ‘Robin’ a success," emphasizes Pasquini.</p></div> </div> <section class="mod mod-text-image " data-ignore="true"> <span class="js-anchorlink" id="Functionality" data-anchor-title="Functionality"></span> <div class="mod-text-image__headline"><h2>High precision human-robot collaboration</h2></div> <div class="row"> <div class="mod-text-image__text col-md-7"> <div class="mod-text-image__copy copy"> <p>So how does an intervention with “Robin” work? Before the procedure begins, the <strong>OR staff meticulously prepares the operating field to ensure smooth interaction between humans and the robotic system.</strong> <strong>Correct positioning of the robotic system is crucial,</strong> enabling seamless integration with the surgical team and efficient maneuverability in the operating room. Precise positioning of the devices and careful calibration of the robotic system are crucial for a smooth, trouble-free workflow throughout the procedure.</p> </div> </div> <figure class="mod-text-image__figure col-md-5"> <picture class="h-ratio h-ratio16-9 h-display-block"> <img alt="" loading=lazy src="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_preparing-the-operating-field.jpg?rev=-1&w=1400&hash=98AACFD4D272EBCAB2CA9894F4A7BB24" srcset="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_preparing-the-operating-field.jpg?rev=-1&w=767&hash=CD1D50DCA20701FB4229FCA94F59864A 767w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_preparing-the-operating-field.jpg?rev=-1&w=1400&hash=98AACFD4D272EBCAB2CA9894F4A7BB24 1400w" sizes="(min-width: 768px) calc(93.75vw/5), (max-width: 767px) 90vw" /> </picture> <figcaption class="row h-margin-top-2"> <span class="col-12 caption-container"> <span class="caption">"Robin" is intuitive and visually appealing.</span> </span> </figcaption> </figure> </div> </section> <div class="mod mod-text" data-ignore="true"> <div class="copy"><p>During the operation, the surgeon uses<strong> infrared markers to map the patient's anatomy on the robotic system. </strong>These markers make the patient "visible" to the device. The system can then track the patient's anatomy and position in real time, ensuring accurate alignment and guidance during the surgical process.</p></div> </div> <figure class="mod mod-image h-pull-row-left-1 h-pull-row-right-1 clearfix" data-ignore="true"> <picture class="h-ratio h-ratio16-9"> <img alt="" src="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokeythe-patients-anatomy-is-registered-and-visualised-on-the-screen.jpg?rev=-1&w=1900&hash=A3BAE6EF977DB50B6F05A751DDBA1495" loading=lazy srcset="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokeythe-patients-anatomy-is-registered-and-visualised-on-the-screen.jpg?rev=-1&w=767&hash=74E01FD552FFBAF1A03B1D0E2E84BE28 767w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokeythe-patients-anatomy-is-registered-and-visualised-on-the-screen.jpg?rev=-1&w=1400&hash=E0F258412C213140271B6C274341F847 1400w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokeythe-patients-anatomy-is-registered-and-visualised-on-the-screen.jpg?rev=-1&w=1900&hash=A3BAE6EF977DB50B6F05A751DDBA1495 1900w" sizes="(min-width: 1px) 93.75vw" /> </picture> <figcaption class="row h-margin-top-2"> <span class="col-12 caption-container"> <span class="caption">As the patient's anatomy is registered and visualised on the screen, the surgeon can now precisely plan the strategy for the bone resections. </span> </span> </figcaption> </figure> <div class="mod mod-text" data-ignore="true"> <div class="copy"><p>As the patient's anatomy is registered and visualised on the screen, <strong>the surgeon can now</strong> <strong>precisely plan the strategy for the bone resections.</strong> The detailed visualisation of the patient's characteristics enables him to develop a suitable approach for the procedure. Once the plan has been finalised, the robotic arm comes into play. <strong>"First, it works in automatic mode and approaches the patient precisely. Once it has reached the intended area, the procedure moves into a collaborative phase. </strong>In this mode, the surgeon can manually adjust the cutting guide held by ’Robin’ to the target plane, with the robotic arm maintaining exceptional accuracy and ensuring that the cutting guide remains precisely positioned throughout the process. This collaborative approach is repeated for each step of the bone resection to ensure consistent precision," says Dr. Alesi, describing the collaboration between physician and medical robot.<br /> <br /> Once all the necessary bone resections have been completed, the <strong>surgeon positions the orthopedic implant on the patient. </strong>During this final phase, he closely monitors the leg kinematics and the overall result on the screen of the robotic system. "This comprehensive monitoring ensures that the implant is placed accurately and that the desired surgical result is achieved. Once the surgeon has confirmed the success of the procedure, the operation is complete and the patient is transferred to post-operative care," says Dr. Alesi. </p></div> </div> <article class="mod mod-text" data-ignore="true"> <span class="js-anchorlink" id="Marketlaunchandoutlook" data-anchor-title="Market launch and outlook"></span> <div class="mod-text__headline"><h2>Partner in the operating room</h2></div> <div class="copy"><p><b>“Robin” is ready for the market.</b> Certification in accordance with the Medical Device Regulation (MDR) is currently underway, after which Orthokey intends to apply for further approvals in various countries – next year, for example, with the Food and Drug Administration (FDA) in the USA. "To achieve this and continuously improve our system, we are working with several reference centers around the world. The feedback has been consistently positive. Users appreciate the dimensions and weight of ’Robin’ as well as the simplicity of the surgical workflow," says Simone Bignozzi.</p> <p> </p><p>It is important to the developers <b>that the medical robot is not seen as a competitor to the surgeon, but as an assistant in the operating room.</b> It can be a great advantage for young surgeons in particular, as they might have a steeper learning curve than in conventional surgery. <b>"’Robin’ will not restrict work opportunities, but will increase the skills of those involved. </b>OR staff, including surgeons, will learn how to interact seamlessly with the additional device. The surgeon will benefit from patient-centered surgery and outliers can be reduced, especially for surgeons with a low number of operations. There will be an impact on the operating room set-up, but this impact will be minimal. Better training of residents and fellows, a better understanding of knee surgery procedures, the collection of more reliable data and a promotion of the further development of surgical practice can be additional benefits of the system," emphasizes Maria Pasquini.</p></div> </article> <figure class="mod mod-image skin-image-fullwidth h-pos-relative clearfix"> <picture class="h-fullwidth-wrapper"> <span class="h-fullwidth-wrapper__content"> <span class="h-ratio h-ratio16-9"> <img alt="" src="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_positions-the-orthopedic-implant-on-the-patient.jpg?rev=-1&w=1900&hash=C765F3394B8F95733CD2951E05C2A68E" loading=lazy srcset="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_positions-the-orthopedic-implant-on-the-patient.jpg?rev=-1&w=767&hash=62C839903E093CF311360291D8A896E2 767w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_positions-the-orthopedic-implant-on-the-patient.jpg?rev=-1&w=1400&hash=8B997CEEABF04105A735DB3C45DE8D47 1400w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_robin_positions-the-orthopedic-implant-on-the-patient.jpg?rev=-1&w=1900&hash=C765F3394B8F95733CD2951E05C2A68E 1900w" sizes="(min-width: 1px) 100vw" /> </span> </span> </picture> <figcaption class="mod-image__figcaption row h-pull-row-right-1 h-pos-relative"> <span class="mod-image__caption col-8 col-md-4 col-xl-3 js-animate-caption"> <span class="caption">The robot system allows the surgeon to plan the right positioning of the implant for each individual patient before performing a resection.</span> </span> </figcaption> </figure> <section class="mod mod-text-image " data-ignore="true"> <div class="mod-text-image__headline"><h2>Robotic knee surgery at a new level</h2></div> <div class="row"> <div class="mod-text-image__text col-md-7"> <div class="mod-text-image__copy copy"> <p>Dr. Domenico Alesi is also certain that “Robin” will take surgical procedures to a new level. "The solution aims to <strong>improve the accuracy of the procedure</strong> in the short term, to <strong>reduce the number of surgical gestures, to reduce variability between surgeons and to lead to reproducible and more precise results.</strong> All of this could be reflected in a better surgical outcome. In the medium term, this will allow us to further develop surgical procedures and the detection of the most important influencing factors," says the surgeon.</p> </div> </div> <figure class="mod-text-image__figure col-md-5"> <picture class="h-ratio h-ratio16-9 h-display-block"> <img alt="" loading=lazy src="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_correct-positioning-of-the-robotic-system.jpg?rev=-1&w=1400&hash=93ABDF677167A0AEEE03527AFFB2BA12" srcset="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_correct-positioning-of-the-robotic-system.jpg?rev=-1&w=767&hash=D9914F024C9DDC905EFE54BEFA12181C 767w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_correct-positioning-of-the-robotic-system.jpg?rev=-1&w=1400&hash=93ABDF677167A0AEEE03527AFFB2BA12 1400w" sizes="(min-width: 768px) calc(93.75vw/5), (max-width: 767px) 90vw" /> </picture> <figcaption class="row h-margin-top-2"> <span class="col-12 caption-container"> <span class="caption">"Robin" is ready for the market.</span> </span> </figcaption> </figure> </div> </section> <div class="mod mod-quote" data-ignore="true"> <div class="row"> <div class="mod-quote__container col-4 offset-4 col-md-2 offset-md-5"> <figure class="mod-quote__figure h-rounded"> <img src="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_portrait_begnozzi.jpg?rev=-1&w=250&hash=59161FA8CD70C181B2E97A63A4981A32" alt="" loading=lazy title="" height="150" width="150" /> </figure> </div> </div> <div class="row"> <div class="col-12 col-md-10 offset-md-1 col-lg-8 offset-lg-2"> <blockquote class="mod-quote__blockquote"> <p class="mod-quote__quote mod-quote__quote-image" style="quotes: '“' '”'"> The accuracy of the system is amazing and it is suitable not only for highly specialised surgeons, but for a wide range of doctors. </p> <footer> <cite class="mod-quote__cite">Dr. Domenico Alesi, orthopedic surgeon at the Istituto Ortopedico Rizzoli in Bologna</cite> </footer> </blockquote> </div> </div> </div> <figure class="mod mod-image h-pull-row-left-1 h-pull-row-right-1 clearfix" data-ignore="true"> <picture class="h-ratio h-ratio16-9"> <img alt="" src="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_assistant-in-the-operating-room.jpg?rev=-1&w=1900&hash=72369827C4632BA43453E0365A605B10" loading=lazy srcset="/-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_assistant-in-the-operating-room.jpg?rev=-1&w=767&hash=EF33EA89859B430583D7517B6526F71F 767w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_assistant-in-the-operating-room.jpg?rev=-1&w=1400&hash=CBE9EC30A2DED440B9C8688502986786 1400w, /-/media/kuka-corporate/images/industries/case-studies/orthokey/orthokey_assistant-in-the-operating-room.jpg?rev=-1&w=1900&hash=72369827C4632BA43453E0365A605B10 1900w" sizes="(min-width: 1px) 93.75vw" /> </picture> <figcaption class="row h-margin-top-2"> <span class="col-12 caption-container"> <span class="caption">It is important to the developers that the medical robot is not seen as a competitor to the surgeon, but as an assistant in the operating room.</span> </span> </figcaption> </figure> <div class="mod mod-text" data-ignore="true"> <div class="copy"><p>Frédéric Piasek, Business Development Manager Medical at KUKA, is looking forward to it: „We have an extremely good and open partnership with Orthokey. Thanks to the constant dialogue about technical challenges, we have been able to make gradual progress with the solution. Also, we are in regular contact regarding potential developments. I’m curious to see what the future of our collaboration with Orthokey has in store for us.“</p></div> </div> <a class="mod mod-bannerteaser row h-pos-relative h-pull-row-right-1 h-pull-row-left-1 background-dark-gray" href="/en-se/industries/system-partners" data-ignore="true" > <span class="js-anchorlink" id="Systempartner" data-anchor-title="System partners"></span> <figure class="mod-bannerteaser__image col-md-8"> <picture class="h-ratio h-ratio16-9"> <img alt="" src="/-/media/kuka-corporate/images/about-kuka/standorte-teaser.jpg?rev=-1&w=1400&hash=46DE3118EE6D164AB6D1C616952D0D0B" loading=lazy srcset="/-/media/kuka-corporate/images/about-kuka/standorte-teaser.jpg?rev=-1&w=767&hash=2AF4683647E67F647A06771005792C5C 767w, /-/media/kuka-corporate/images/about-kuka/standorte-teaser.jpg?rev=-1&w=1400&hash=46DE3118EE6D164AB6D1C616952D0D0B 1400w" sizes="(min-width: 1px) 93.75vw" /> </picture> </figure> <div class="mod-bannerteaser__cta col-md-4 text-center"> <h3 class="h-margin-top-0 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