Sensor based surgical robotics

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The treatment of femoral shaft fractures has shifted towards minimally invasive intramedullary nailing, which, despite its advantages, presents challenges such as malaligned reductions that can adversely affect patient rehabilitation and biomechanics. Additionally, high X-ray exposure poses risks for the surgical team, highlighting the need for advanced technical support during procedures. An interdisciplinary project between Hannover Medical School and the Technical University of Braunschweig explores the use of robotic surgical assistance in this area. This thesis, stemming from that project, demonstrates how robotic systems can aid surgeons in the reduction of fractured bone fragments. It details the development of a telemanipulator system capable of performing reductions using 2D and 3D imaging data, evaluated on both exposed bones and human specimens. Building on this, a concept for a (semi-)automated robotized reduction procedure is introduced, which computes a trajectory that minimizes soft tissue trauma while executing the reduction using sensor-guided motions. Additionally, automated image analysis methods enhance the robot's precision as a drill guidance tool. The integration of surgical navigation and robotics also improves the insertion of intramedullary nails and distal locking, with a proposed workflow utilizing Petri-nets and skill primitives to ensure reliable execution of tasks. Overall, the methods developed