Robotically equipped 3D hybrid operating room in spine and trauma surgery – updated experience in 359 patients and 2080 screws

{"Modern":[0],"techniques,":[1],"such":[2],"as":[3],"robotics":[4],"and":[5,24,44,67,110,135,137,145,158,231,251,270,315,326],"navigation,":[6],"alongside":[7],"cutting-edge":[8],"imaging":[9],"solutions":[10],"like":[11],"cone":[12,90],"beam":[13,91],"CT":[14,92],"imaging,":[15],"are":[16],"playing":[17],"an":[18,177,199],"increasingly":[19],"prominent":[20],"role":[21],"in":[22,47,227,237,255,266,330],"spine":[23],"trauma":[25,59,143,297],"surgery":[26],"within":[27],"so-called":[28],"Hybrid":[29,53,84,283],"ORs.":[30],"This":[31,277],"study":[32,152,278],"aims":[33],"to":[34,36,154],"contribute":[35],"the":[37,48,125,130,232,290,306],"ongoing":[38],"scientific":[39],"discussion":[40],"surrounding":[41],"accuracy":[42,156,178,200,210,313],"rates":[43,157,314],"learning":[45,159,246,324],"curves":[46],"utilisation":[49],"of":[50,87,150,183,191,202,212,293],"a":[51,56,61,68,88,94,100,106,244,252,281,294,322,327],"modern":[52],"OR.":[54],"In":[55,161],"Level":[57],"1":[58,296],"centre,":[60],"3D":[62,113],"Navigation-Hybrid":[63],"OR":[64,85,284],"was":[65,72,80,215,235],"implemented,":[66],"prospective":[69],"data":[70],"collection":[71],"launched":[73],"(March":[74],"2022":[75],"-":[76,187,206,220],"June":[77],"2025).":[78],"Analysis":[79],"performed":[81],"retrospectively.":[82],"The":[83,148,208],"consists":[86],"robotic":[89,95,233],"\\"Loop-X\\",":[93],"arm":[96,234],"\\"Cirq":[97],"Arm":[98],"System\\",":[99,105],"navigation":[101],"unit":[102],"\\"Curve":[103],"Navigation":[104],"wall-mounted":[107],"monitor":[108],"\\"BUZZ\\"":[109],"Elements":[111],"Viewer":[112],"mixed":[114],"reality":[115],"glasses":[116],"for":[117,303],"planning":[118],"(Brainlab,":[119],"Munich,":[120],"Germany).":[121],"Intervention":[122],"areas":[123],"included":[124],"entire":[126,307],"skeletal":[127,308],"system,":[128,309],"encompassing":[129],"spine,":[131],"pelvis":[132],"(pelvic":[133],"ring":[134],"acetabulum),":[136],"extremities,":[138],"with":[139,176,198,310],"various":[140],"indications,":[141],"primarily":[142],"(fractures)":[144],"oncology":[146],"(tumours).":[147],"focus":[149],"this":[151],"is":[153],"assess":[155],"curves.":[160],"n":[162],"=":[163,261],"359":[164],"patients,":[165],"2080":[166],"screws":[167,173,195],"were":[168,174,196,225],"inserted.":[169],"1881":[170],"(90.4%)":[171],"spinal":[172],"inserted":[175,197],"rate":[179,201,211],"(GR-A":[180],"&":[181],"GR-B)":[182],"98.5%":[184,217],"(CI95%:":[185,204,218],"97.9%":[186],"99.0%).":[188,221],"A":[189],"total":[190],"199":[192],"(9.6%)":[193],"non-spinal":[194],"99.0%":[203],"97.6%":[205],"99.9%).":[207],"overall":[209],"screw":[213],"placement":[214],"therefore":[216],"98.0%":[219],"Minimally":[222],"invasive":[223],"techniques":[224],"used":[226],"243":[228],"(67.7%)":[229],"cases":[230],"utilised":[236],"271":[238],"(75.5%)":[239],"cases.":[240],"Subgroup":[241],"analyses":[242],"revealed":[243],"significant":[245,253,323,328],"curve":[247,325],"(p":[248,260],"<":[249],"0.001)":[250],"reduction":[254,329],"operation":[256,331],"times":[257,332],"over":[258,333],"time":[259],"0.008).":[262],"Wound":[263],"infection":[264],"occurred":[265],"10":[267],"(2.8%)":[268],"cases,":[269],"17":[271],"(4.7%)":[272],"patients":[273],"died":[274],"during":[275],"hospitalisation.":[276],"demonstrates":[279],"that":[280],"3D-Navigation":[282],"can":[285],"be":[286],"successfully":[287],"integrated":[288],"into":[289],"clinical":[291],"routine":[292],"level":[295],"centre.":[298],"It":[299],"shows":[300],"promising":[301],"results":[302],"interventions":[304],"on":[305],"consistently":[311],"high":[312],"low":[316],"complication":[317],"rates.":[318],"Furthermore,":[319],"it":[320],"highlights":[321],"time.":[334]}

Authors

Institutions

Publication Details

Journal
Journal of Robotic Surgery
Published
2026-09-04
DOI
https://doi.org/10.1007/s11701-026-03898-1
Primary Topic
Spinal Fractures and Fixation Techniques
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
article

Robotically equipped 3D hybrid operating room in spine and trauma surgery – updated experience in 359 patients and 2080 screws

Thorsten Enk, Stefan Huber‐Wagner, Friedemann Meiswinkel, Marc Hanschen et al.
Journal of Robotic Surgery
Spinal Fractures and Fixation Techniques
article

Robotically equipped 3D hybrid operating room in spine and trauma surgery – updated experience in 359 patients and 2080 screws

Thorsten Enk, Stefan Huber‐Wagner, Friedemann Meiswinkel, Marc Hanschen, Dominik M Haida, Thorsten Möhlig, Mircea-Andrei Ungureanu, Peter Mohr
article en

Abstract

Modern techniques, such as robotics and navigation, alongside cutting-edge imaging solutions like cone beam CT imaging, are playing an increasingly prominent role in spine and trauma surgery within so-called Hybrid ORs. This study aims to contribute to the ongoing scientific discussion surrounding accuracy rates and learning curves in the utilisation of a modern Hybrid OR. In a Level 1 trauma centre, a 3D Navigation-Hybrid OR was implemented, and a prospective data collection was launched (March 2022 - June 2025). Analysis was performed retrospectively. The Hybrid OR consists of a robotic cone beam CT "Loop-X", a robotic arm "Cirq Arm System", a navigation unit "Curve Navigation System", a wall-mounted monitor "BUZZ" and Elements Viewer 3D mixed reality glasses for planning (Brainlab, Munich, Germany). Intervention areas included the entire skeletal system, encompassing the spine, pelvis (pelvic ring and acetabulum), and extremities, with various indications, primarily trauma (fractures) and oncology (tumours). The focus of this study is to assess accuracy rates and learning curves. In n = 359 patients, 2080 screws were inserted. 1881 (90.4%) spinal screws were inserted with an accuracy rate (GR-A & GR-B) of 98.5% (CI95%: 97.9% - 99.0%). A total of 199 (9.6%) non-spinal screws were inserted with an accuracy rate of 99.0% (CI95%: 97.6% - 99.9%). The overall accuracy rate of screw placement was therefore 98.5% (CI95%: 98.0% - 99.0%). Minimally invasive techniques were used in 243 (67.7%) cases and the robotic arm was utilised in 271 (75.5%) cases. Subgroup analyses revealed a significant learning curve (p < 0.001) and a significant reduction in operation times over time (p = 0.008). Wound infection occurred in 10 (2.8%) cases, and 17 (4.7%) patients died during hospitalisation. This study demonstrates that a 3D-Navigation Hybrid OR can be successfully integrated into the clinical routine of a level 1 trauma centre. It shows promising results for interventions on the entire skeletal system, with consistently high accuracy rates and low complication rates. Furthermore, it highlights a significant learning curve and a significant reduction in operation times over time.

Journal of Robotic SurgeryVol. 20(1)
TUM Klinikum (DE), München Klinik Schwabing (DE)
Technische Universität München
Openalex Percentile: Top 8%
Spinal Fractures and Fixation Techniques
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.