Nottingham Trent Pioneers Surgical Robotic System

Researchers in Nottingham Trent University’s School of Science and Technology are developing a new robotic system designed to perform spinal surgery with pinpoint accuracy and assist in complex deformity reduction manoeuvres.

It’s a new and exciting area of co-robotics: robots which are designed to work safely alongside humans. They are mainly suitable for industrial applications where there’s an element of danger, so where you’d normally see machine guarding or light barriers to prevent accidents. One of the advantages of co-robotics is that they don’t always require guarding as they have a feature that can be set by the user to ensure they stop when coming in to contact with an object or person. Another benefit is that in the future they could be operated by surgeons remotely from anywhere in the world.

The ScoliBot project is being led by Philip Breedon, Professor in Smart Technologies, who after talking to surgeons and clinicians saw a potential opportunity for the use of co-robotics in theatre.

“As far as we are aware for this particular procedure, ScoliBot is unique,” explained Professor Breedon. “There are a few well known surgical robots, such as the da Vinci Robot, already in existence but this is the first of its kind in conducting active surgical steps in spinal surgery.”

Revolutionising spinal surgery

The ScoliBot consists of a datum robot which links with CT scan data and locks onto the vertebra, and a tooling robot which has a drill with a torque converter mounted on the end. During an operation to correct a serious spinal condition such as scoliosis, the surgeon would place the datum robot into position and then, using CT scan data of the patient’s spine, the tooling robot would be able to drill very accurate holes into the vertebra. Pedicle screws would then be inserted into the holes by the robot and attached to deformity rod reducers that allow surgeons to lever individual vertebrae and realign the spine.

Although the ScoliBot is still in the early stages of development, Professor Breedon is confident the technology could revolutionise spinal surgery.

“The core benefits of this system are repeatability, accuracy and safety. The robots are extremely precise and can drill holes accurately and repeatably,” he explained.

“This is obviously hugely beneficial when performing life-changing operations that require pinpoint levels of accuracy to avoid causing unnecessary and potentially serious injuries.

“Also, surgery time could be massively reduced, saving the NHS millions of pounds every year as well as reducing issues like fatigue for the surgeon.”

The project is being developed in conjunction with Professor Bronek Boszczyk who is the Head of the Spine & Scoliosis Centre at the Schoen Clinic in Vogtareuth, Germany.

Professor Bronek said the long-term vision is for the co-robotic arms to actively assist the surgeon in conducting complex reduction manoeuvres in spinal deformity which are currently only accomplished manually.

“In contrast to surgical robots currently in use, the ScoliBot intentionally enters the domain of active surgical steps,” he explained.

“Current systems are passive guides whereby the robot places the drill guide in the correct position for the surgeon to drill. With ScoliBot one arm is attached to the vertebra via a patent-pending interface which allows the robot to continuously ‘see’ where the vertebra is while the second tooling arm drills and places the screws even while the spine moves during the patient breathing.

“The instant feedback of this system provides greater safety than conventional passive navigation systems.”

Medical technologies innovation 

The ScoliBot is just one of the projects under development at Nottingham Trent University which is currently building a new £23m Medical Technologies Innovation Facility (MTIF).

MTIF Managing Director Mike Hannay said one of their key aims is to improve patient care by speeding up medical product development and getting innovations to market as quickly as possible.

“There’s one thing that’s missing in the medical technologies industry and that’s the capability to go from bench to bedside – by that I mean taking very early research and being able to translate that into products that benefit patients.

“MTIF will enable us to build on the core capabilities that a university has and work with strategic partners, such as the local NHS trusts and organisations that support industry, to enable what could be a virtual company to go from very basic research all the way through clinical trials and registration to get their product onto the market.”

Planned for the Boots Enterprise Zone in Nottingham, the new facility is expected to open in summer 2020 and has been part funded by the D2N2 Local Enterprise Partnership.