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

J Orthop Surg Res. 2024 Apr 22;19(1):253. doi: 10.1186/s13018-024-04731-x.

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.

MeSH terms

  • Acetabulum* / injuries
  • Acetabulum* / surgery
  • Adult
  • Bone Plates*
  • Female
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • Fractures, Bone* / surgery
  • Humans
  • Male
  • Minimally Invasive Surgical Procedures / instrumentation
  • Minimally Invasive Surgical Procedures / methods
  • Robotic Surgical Procedures* / methods