Robotic Skull Contouring for Facial Reconstruction-A Cadaveric Study

Area of Science:

• Medical Engineering
• Robotics in Surgery
• Craniofacial Surgery

Background:

• Orbital trauma causes complex facial injuries impacting function and aesthetics.
• Autologous calvarial bone grafting is the standard for orbital fractures but manual carving is imprecise and time-consuming.
• Inaccuracies in manual carving can negatively affect cosmetic and functional outcomes.

Purpose of the Study:

• To evaluate the accuracy and efficiency of robotic bone graft carving for orbital defect repair.
• To compare robotic carving outcomes with traditional manual carving methods.

Main Methods:

• Simulated orbital defects in 8 orbits.
• Harvested calvarial bone was robotically carved using virtual preoperative planning.
• Accuracy assessed via surface deviation maps; efficiency measured by carving time; compared with manual carving operative times.

Main Results:

• Robotic carving achieved submillimeter accuracy (0.25-0.38 mm RMS error).
• Carving time reduced from over 40 minutes to under 12 minutes after optimization.
• Average manual carving operative time was 55 minutes.

Conclusions:

• Robotic-assisted bone carving presents a highly accurate and efficient alternative for orbital reconstruction.
• This technique has the potential to enhance reconstructive accuracy and surgical efficiency.
• Further operating room validation is recommended.