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：

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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 difference was 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 difference was 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 difference was found between the two groups in maximum residual displacement, reduction quality, or screw placement accuracy (P>0.05). All patients were followed up 7-16 months (mean, 11.3 months), with no significant difference in follow-up duration between the groups (P>0.05). No perioperative or follow-up complication, 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 difference was found in incidences of squatting limitation or persistent pain (P>0.05). At last follow-up, no significant difference was 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.

Citation： DAI Yonghong, YANG Kuangyang, ZENG Yanhui, HAN Wei, WANG Junqiang. Effectiveness analysis of 5G remote robotic surgery in pelvic fracture treatment. Chinese Journal of Reparative and Reconstructive Surgery, 2025, 39(4): 391-398. doi: 10.7507/1002-1892.202501052 Copy

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, 趙春鵬, 卑明健, 等. 智能化骨盆骨折復位手術導航定位系統在骨盆骨折治療中的初步應用. 中華骨科雜志, 2023, 43(19): 1293-1299.
3.	饒福濤, 曾詩晨. 損傷控制理論在骨盆骨折患者中的應用進展. 醫學綜述, 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.	韓波, 侯秀秀, 李運美, 等. 5G遠程控制骨科機器人輔助骨盆髖臼骨折經皮通道螺釘置入的安全性和有效性分析. 創傷外科雜志, 2024, 26(7): 501-505.
6.	趙斌, 李金奇, 趙春鵬, 等. 基于5G技術的骨科機器人遠程導航輔助植入經皮骨盆通道螺釘固定骨盆及髖臼骨折. 中國修復重建外科雜志, 2022, 36(8): 923-928.
7.	中華醫學會骨科學分會創傷骨科學組, 中華醫學會骨科學分會外固定與肢體重建學組, 中華醫學會創傷學分會, 等. 中國骨盆骨折微創手術治療指南(2021). 中華創傷骨科雜志, 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.	李濤. TiRobot機器人輔助下經皮螺釘內固定治療骨盆骨折的臨床效果分析. 濟南: 山東大學, 2021.
10.	賈健. 骨科定位機器人在骨盆髖臼骨折手術治療中的應用. 中華骨科雜志, 2023, 43(19): 1334-1342.
11.	趙春鵬, 王軍強, 蘇永剛, 等. 機器人輔助經皮螺釘內固定治療骨盆和髖臼骨折. 北京大學學報 (醫學版), 2017, 49(2): 274-280.
12.	李鵬. 機器人輔助與傳統透視輔助置入骶髂螺釘治療骨盆后環骨折的Meta分析. 太原: 山西醫科大學, 2023.
13.	Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg (Br), 1989, 71(2): 304-306.
14.	王軍強, 趙春鵬, 胡磊, 等. 遠程外科機器人輔助脛骨髓內釘內固定系統的初步應用. 中華骨科雜志, 2006, 26(10): 682-686.
15.	李松巖, 聞巍, 戴飛翔, 等. 超遠程手術機器人輔助直腸癌根治術臨床初步研究. 中國實用外科雜志, 2024, 44(3): 308-311.
16.	Nakauchi M, Suda K, Nakamura K, et al. Establishment of a new practical telesurgical platform using the hinotori^TM 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, 徐瑋, 劉雷, 等. 天璣骨科機器人Tirobot導航系統在骨盆骨折手術中的應用. 生物骨科材料與臨床研究, 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.	楊成志, 劉剛, 唐經勵, 等. 天璣骨科機器人輔助經皮骶髂空心螺釘內固定治療骨盆后環損傷合并骶骨變異. 中國修復重建外科雜志, 2022, 36(8): 940-945.
23.	葛碩, 張雷, 周子斐, 等. 天璣骨科機器人聯合O臂導航系統輔助經皮微創治療骨盆后環損傷. 中國修復重建外科雜志, 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.	楊光, 祁寶昌, 趙天昊, 等. TiRobot骨科手術機器人輔助下微創經皮通道螺釘固定治療骨盆骨折的療效分析. 中華創傷骨科雜志, 2022, 24(3): 200-205.
26.	張澤平, 李祖曦, 喬吉靈, 等. 5G遠程機器人手術應用現狀及前景. 中國實用外科雜志, 2024, 44(7): 836-838, 840.
27.	景武堂, 萬浩浩, 苗長豐, 等. 5G遠程機器人手術的應用現狀及展望. 機器人外科學雜志 (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, 趙春鵬, 卑明健, 等. 智能化骨盆骨折復位手術導航定位系統在骨盆骨折治療中的初步應用. 中華骨科雜志, 2023, 43(19): 1293-1299.
3. 饒福濤, 曾詩晨. 損傷控制理論在骨盆骨折患者中的應用進展. 醫學綜述, 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. 韓波, 侯秀秀, 李運美, 等. 5G遠程控制骨科機器人輔助骨盆髖臼骨折經皮通道螺釘置入的安全性和有效性分析. 創傷外科雜志, 2024, 26(7): 501-505.
6. 趙斌, 李金奇, 趙春鵬, 等. 基于5G技術的骨科機器人遠程導航輔助植入經皮骨盆通道螺釘固定骨盆及髖臼骨折. 中國修復重建外科雜志, 2022, 36(8): 923-928.
7. 中華醫學會骨科學分會創傷骨科學組, 中華醫學會骨科學分會外固定與肢體重建學組, 中華醫學會創傷學分會, 等. 中國骨盆骨折微創手術治療指南(2021). 中華創傷骨科雜志, 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. 李濤. TiRobot機器人輔助下經皮螺釘內固定治療骨盆骨折的臨床效果分析. 濟南: 山東大學, 2021.
10. 賈健. 骨科定位機器人在骨盆髖臼骨折手術治療中的應用. 中華骨科雜志, 2023, 43(19): 1334-1342.
11. 趙春鵬, 王軍強, 蘇永剛, 等. 機器人輔助經皮螺釘內固定治療骨盆和髖臼骨折. 北京大學學報 (醫學版), 2017, 49(2): 274-280.
12. 李鵬. 機器人輔助與傳統透視輔助置入骶髂螺釘治療骨盆后環骨折的Meta分析. 太原: 山西醫科大學, 2023.
13. Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg (Br), 1989, 71(2): 304-306.
14. 王軍強, 趙春鵬, 胡磊, 等. 遠程外科機器人輔助脛骨髓內釘內固定系統的初步應用. 中華骨科雜志, 2006, 26(10): 682-686.
15. 李松巖, 聞巍, 戴飛翔, 等. 超遠程手術機器人輔助直腸癌根治術臨床初步研究. 中國實用外科雜志, 2024, 44(3): 308-311.
16. Nakauchi M, Suda K, Nakamura K, et al. Establishment of a new practical telesurgical platform using the hinotori^TM 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, 徐瑋, 劉雷, 等. 天璣骨科機器人Tirobot導航系統在骨盆骨折手術中的應用. 生物骨科材料與臨床研究, 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. 楊成志, 劉剛, 唐經勵, 等. 天璣骨科機器人輔助經皮骶髂空心螺釘內固定治療骨盆后環損傷合并骶骨變異. 中國修復重建外科雜志, 2022, 36(8): 940-945.
23. 葛碩, 張雷, 周子斐, 等. 天璣骨科機器人聯合O臂導航系統輔助經皮微創治療骨盆后環損傷. 中國修復重建外科雜志, 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. 楊光, 祁寶昌, 趙天昊, 等. TiRobot骨科手術機器人輔助下微創經皮通道螺釘固定治療骨盆骨折的療效分析. 中華創傷骨科雜志, 2022, 24(3): 200-205.
26. 張澤平, 李祖曦, 喬吉靈, 等. 5G遠程機器人手術應用現狀及前景. 中國實用外科雜志, 2024, 44(7): 836-838, 840.
27. 景武堂, 萬浩浩, 苗長豐, 等. 5G遠程機器人手術的應用現狀及展望. 機器人外科學雜志 (中英文), 2025, 6(1): 1-5.

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