Effectiveness analysis of 5G remote robotic surgery in pelvic fracture treatment_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

DAI Yonghong ¹ ,  YANG Kuangyang ^1,2 , ZENG Yanhui ^1,2 , HAN Wei ³ , WANG Junqiang ³

1. The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine, Foshan Guangdong, 528000, P. R. China;
2. Department of Orthopedic Trauma, Foshan Hospital of Traditional Chinese Medicine, Foshan Guangdong, 528000, P. R. China;
3. Department of Orthopedic Trauma, Beijing Jishuitan Hospital, Capital Medical University, Beijing, 100035, P. R. China;

Corresponding author：

YANG Kuangyang, Email: yzysxdlw@163.com

Keywords：

Remote surgery; collaborative diagnosis and treatment; pelvic fracture; 5G communication technology; TiRobot

DOI：

10.7507/1002-1892.202501052

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the effectiveness of 5G remote robotic surgery in the treatment of pelvic fractures. Methods A retrospective analysis was conducted on the clinical data of 160 patients with pelvic fractures admitted between July 2023 and June 2024 who met the selection criteria. Among these patients, 80 underwent internal fixation surgery with the assistance of 5G remote robotic surgery (5G group), while 80 received local robotic surgical assistance (control group). Baseline characteristics, including gender, age, body mass index, disease duration, cause of injury, and fracture classification, were compared between the two groups, and no significant differences were found (P>0.05). The incision length, operation time, intraoperative blood loss, hospital stay, accuracy of screw placement, maximum residual displacement postoperatively, quality of fracture reduction, incidence of complications, Majeed pelvic function score and classification at last follow-up were recorded and compared between the two groups. Results In the 5G group, 180 screws were implanted during surgery, while 213 screws were implanted in the control group. The 5G group demonstrated significantly reduced intraoperative blood loss and shorter incision length compared to the control group (P<0.05). No significant differences were observed between the two groups in terms of operation time or hospital stay (P>0.05). Radiographic evaluation revealed excellent and good reduction rates of 98.8% (79/80) in the 5G group and 97.5% (78/80) in the control group, while excellent and good screw placement accuracy rates were 98.3% (177/180) in the 5G group and 95.8% (204/213) in the control group. No significant differences were found between the two groups in maximum residual displacement, reduction quality, or screw placement accuracy (P>0.05). All patients were followed up for a mean duration of 11.3 months (range, 7-16 months), with no significant difference in follow-up duration between the groups (P>0.05). No perioperative or follow-up complications, such as wound infection, iatrogenic fractures, iatrogenic neurovascular injury, screw loosening or breakage, or nonunion, were observed in either group. The control group exhibited a worse degree of gait alteration compared to the 5G group (P<0.05), while no significant differences were found in incidences of squatting limitation or persistent pain (P>0.05). At last follow-up, no significant differences were observed between the groups in Majeed pelvic function scores or grading (P>0.05). Conclusion Compared with the local surgery group, 5G remote robotic surgery supported by remote expert technical guidance demonstrated smaller incision lengths, less intraoperative blood loss, and fewer postoperative complications, and was shown to be a precise, minimally invasive, safe, and reliable surgical method.

1.	Zhao C, Wang Y, Wu X, et al. Design and evaluation of an intelligent reduction robot system for the minimally invasive reduction in pelvic fractures. J Orthop Surg Res, 2022, 17(1): 205. doi: 10.1186/s13018-022-03089-2.
2.	曹奇勇, 赵春鹏, 卑明健, 等. 智能化骨盆骨折复位手术导航定位系统在骨盆骨折治疗中的初步应用. 中华骨科杂志, 2023, 43(19): 1293-1299.
3.	饶福涛, 曾诗晨. 损伤控制理论在骨盆骨折患者中的应用进展. 医学综述, 2021, 27(3): 550-554.
4.	Smith W, Williams A, Agudelo J, et al. Early predictors of mortality in hemodynamically unstable pelvis fractures. J Orthop Trauma, 2007, 21(1): 31-37.
5.	韩波, 侯秀秀, 李运美, 等. 5G远程控制骨科机器人辅助骨盆髋臼骨折经皮通道螺钉置入的安全性和有效性分析. 创伤外科杂志, 2024, 26(7): 501-505.
6.	赵斌, 李金奇, 赵春鹏, 等. 基于5G技术的骨科机器人远程导航辅助植入经皮骨盆通道螺钉固定骨盆及髋臼骨折. 中国修复重建外科杂志, 2022, 36(8): 923-928.
7.	中华医学会骨科学分会创伤骨科学组, 中华医学会骨科学分会外固定与肢体重建学组, 中华医学会创伤学分会, 等. 中国骨盆骨折微创手术治疗指南(2021). 中华创伤骨科杂志, 2021, 23(1): 4-14.
8.	Yu YH, Liu CH, Hsu YH, et al. Matta’s criteria may be useful for evaluating and predicting the reduction quality of simultaneous acetabular and ipsilateral pelvic ring fractures. BMC Musculoskelet Disord, 2021, 22(1): 544. doi: 10.1186/s12891-021-04441-z.
9.	李涛. TiRobot机器人辅助下经皮螺钉内固定治疗骨盆骨折的临床效果分析. 济南: 山东大学, 2021.
10.	贾健. 骨科定位机器人在骨盆髋臼骨折手术治疗中的应用. 中华骨科杂志, 2023, 43(19): 1334-1342.
11.	赵春鹏, 王军强, 苏永刚, 等. 机器人辅助经皮螺钉内固定治疗骨盆和髋臼骨折. 北京大学学报 (医学版), 2017, 49(2): 274-280.
12.	李鹏. 机器人辅助与传统透视辅助置入骶髂螺钉治疗骨盆后环骨折的Meta分析. 太原: 山西医科大学, 2023.
13.	Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg (Br), 1989, 71(2): 304-306.
14.	王军强, 赵春鹏, 胡磊, 等. 远程外科机器人辅助胫骨髓内钉内固定系统的初步应用. 中华骨科杂志, 2006, 26(10): 682-686.
15.	李松岩, 闻巍, 戴飞翔, 等. 超远程手术机器人辅助直肠癌根治术临床初步研究. 中国实用外科杂志, 2024, 44(3): 308-311.
16.	Nakauchi M, Suda K, Nakamura K, et al. Establishment of a new practical telesurgical platform using the hinotori™ Surgical Robot System: a preclinical study. Langenbecks Arch Surg, 2022, 407(8): 3783-3791.
17.	Xu S, Perez M, Yang K, et al. Determination of the latency effects on surgical performance and the acceptable latency levels in telesurgery using the dV-Trainer(^®) simulator. Surg Endosc, 2014, 28(9): 2569-2576.
18.	Korte C, Nair SS, Nistor V, et al. Determining the threshold of time-delay for teleoperation accuracy and efficiency in relation to telesurgery. Telemed J E Health, 2014, 20(12): 1078-1086.
19.	夏睿, 徐玮, 刘雷, 等. 天玑骨科机器人Tirobot导航系统在骨盆骨折手术中的应用. 生物骨科材料与临床研究, 2023, 20(2): 60-64.
20.	Li N, Zhu Z, Xiao C, et al. The efficacy of “TiRobot” orthopaedic robot-assisted vs conventional fluoroscopic percutaneous screw fixation of the sacroiliac joint. Int Orthop, 2023, 47(2): 351-358.
21.	Zhao C, Zhu G, Wang Y, et al. TiRobot-assisted versus conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation for pelvic ring injuries: a meta-analysis. J Orthop Surg Res, 2022, 17(1): 525. doi: 10.1186/s13018-022-03420-x.
22.	杨成志, 刘刚, 唐经励, 等. 天玑骨科机器人辅助经皮骶髂空心螺钉内固定治疗骨盆后环损伤合并骶骨变异. 中国修复重建外科杂志, 2022, 36(8): 940-945.
23.	葛硕, 张雷, 周子斐, 等. 天玑骨科机器人联合O臂导航系统辅助经皮微创治疗骨盆后环损伤. 中国修复重建外科杂志, 2022, 36(8): 934-939.
24.	Han W, Zhang T, Su YG, et al. Percutaneous robot-assisted versus freehand S₂ iliosacral screw fixation in unstable posterior pelvic ring fracture. Orthop Surg, 2022, 14(2): 221-228.
25.	杨光, 祁宝昌, 赵天昊, 等. TiRobot骨科手术机器人辅助下微创经皮通道螺钉固定治疗骨盆骨折的疗效分析. 中华创伤骨科杂志, 2022, 24(3): 200-205.
26.	张泽平, 李祖曦, 乔吉灵, 等. 5G远程机器人手术应用现状及前景. 中国实用外科杂志, 2024, 44(7): 836-838, 840.
27.	景武堂, 万浩浩, 苗长丰, 等. 5G远程机器人手术的应用现状及展望. 机器人外科学杂志 (中英文), 2025, 6(1): 1-5.

1. Zhao C, Wang Y, Wu X, et al. Design and evaluation of an intelligent reduction robot system for the minimally invasive reduction in pelvic fractures. J Orthop Surg Res, 2022, 17(1): 205. doi: 10.1186/s13018-022-03089-2.
2. 曹奇勇, 赵春鹏, 卑明健, 等. 智能化骨盆骨折复位手术导航定位系统在骨盆骨折治疗中的初步应用. 中华骨科杂志, 2023, 43(19): 1293-1299.
3. 饶福涛, 曾诗晨. 损伤控制理论在骨盆骨折患者中的应用进展. 医学综述, 2021, 27(3): 550-554.
4. Smith W, Williams A, Agudelo J, et al. Early predictors of mortality in hemodynamically unstable pelvis fractures. J Orthop Trauma, 2007, 21(1): 31-37.
5. 韩波, 侯秀秀, 李运美, 等. 5G远程控制骨科机器人辅助骨盆髋臼骨折经皮通道螺钉置入的安全性和有效性分析. 创伤外科杂志, 2024, 26(7): 501-505.
6. 赵斌, 李金奇, 赵春鹏, 等. 基于5G技术的骨科机器人远程导航辅助植入经皮骨盆通道螺钉固定骨盆及髋臼骨折. 中国修复重建外科杂志, 2022, 36(8): 923-928.
7. 中华医学会骨科学分会创伤骨科学组, 中华医学会骨科学分会外固定与肢体重建学组, 中华医学会创伤学分会, 等. 中国骨盆骨折微创手术治疗指南(2021). 中华创伤骨科杂志, 2021, 23(1): 4-14.
8. Yu YH, Liu CH, Hsu YH, et al. Matta’s criteria may be useful for evaluating and predicting the reduction quality of simultaneous acetabular and ipsilateral pelvic ring fractures. BMC Musculoskelet Disord, 2021, 22(1): 544. doi: 10.1186/s12891-021-04441-z.
9. 李涛. TiRobot机器人辅助下经皮螺钉内固定治疗骨盆骨折的临床效果分析. 济南: 山东大学, 2021.
10. 贾健. 骨科定位机器人在骨盆髋臼骨折手术治疗中的应用. 中华骨科杂志, 2023, 43(19): 1334-1342.
11. 赵春鹏, 王军强, 苏永刚, 等. 机器人辅助经皮螺钉内固定治疗骨盆和髋臼骨折. 北京大学学报 (医学版), 2017, 49(2): 274-280.
12. 李鹏. 机器人辅助与传统透视辅助置入骶髂螺钉治疗骨盆后环骨折的Meta分析. 太原: 山西医科大学, 2023.
13. Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg (Br), 1989, 71(2): 304-306.
14. 王军强, 赵春鹏, 胡磊, 等. 远程外科机器人辅助胫骨髓内钉内固定系统的初步应用. 中华骨科杂志, 2006, 26(10): 682-686.
15. 李松岩, 闻巍, 戴飞翔, 等. 超远程手术机器人辅助直肠癌根治术临床初步研究. 中国实用外科杂志, 2024, 44(3): 308-311.
16. Nakauchi M, Suda K, Nakamura K, et al. Establishment of a new practical telesurgical platform using the hinotori™ Surgical Robot System: a preclinical study. Langenbecks Arch Surg, 2022, 407(8): 3783-3791.
17. Xu S, Perez M, Yang K, et al. Determination of the latency effects on surgical performance and the acceptable latency levels in telesurgery using the dV-Trainer(^®) simulator. Surg Endosc, 2014, 28(9): 2569-2576.
18. Korte C, Nair SS, Nistor V, et al. Determining the threshold of time-delay for teleoperation accuracy and efficiency in relation to telesurgery. Telemed J E Health, 2014, 20(12): 1078-1086.
19. 夏睿, 徐玮, 刘雷, 等. 天玑骨科机器人Tirobot导航系统在骨盆骨折手术中的应用. 生物骨科材料与临床研究, 2023, 20(2): 60-64.
20. Li N, Zhu Z, Xiao C, et al. The efficacy of “TiRobot” orthopaedic robot-assisted vs conventional fluoroscopic percutaneous screw fixation of the sacroiliac joint. Int Orthop, 2023, 47(2): 351-358.
21. Zhao C, Zhu G, Wang Y, et al. TiRobot-assisted versus conventional fluoroscopy-assisted percutaneous sacroiliac screw fixation for pelvic ring injuries: a meta-analysis. J Orthop Surg Res, 2022, 17(1): 525. doi: 10.1186/s13018-022-03420-x.
22. 杨成志, 刘刚, 唐经励, 等. 天玑骨科机器人辅助经皮骶髂空心螺钉内固定治疗骨盆后环损伤合并骶骨变异. 中国修复重建外科杂志, 2022, 36(8): 940-945.
23. 葛硕, 张雷, 周子斐, 等. 天玑骨科机器人联合O臂导航系统辅助经皮微创治疗骨盆后环损伤. 中国修复重建外科杂志, 2022, 36(8): 934-939.
24. Han W, Zhang T, Su YG, et al. Percutaneous robot-assisted versus freehand S₂ iliosacral screw fixation in unstable posterior pelvic ring fracture. Orthop Surg, 2022, 14(2): 221-228.
25. 杨光, 祁宝昌, 赵天昊, 等. TiRobot骨科手术机器人辅助下微创经皮通道螺钉固定治疗骨盆骨折的疗效分析. 中华创伤骨科杂志, 2022, 24(3): 200-205.
26. 张泽平, 李祖曦, 乔吉灵, 等. 5G远程机器人手术应用现状及前景. 中国实用外科杂志, 2024, 44(7): 836-838, 840.
27. 景武堂, 万浩浩, 苗长丰, 等. 5G远程机器人手术的应用现状及展望. 机器人外科学杂志 (中英文), 2025, 6(1): 1-5.

Chinese Journal of Reparative and Reconstructive Surgery

Latest ArticlesEffectiveness analysis of 5G remote robotic surgery in pelvic fracture treatment

Abstract Full text Figures/Tables Video References Cited by

Format

Content