Robotics in Orthopedics and Neurosurgery

A major challenge ahead in surgical robotics is to advance the intelligence, autonomy and overall capabilities of these systems. While current robotic technologies augment human capabilities, they still depend heavily on direct human control. Achieving greater autonomy requires extensive research into advanced robotic artificial intelligence (AI) that can make autonomous decisions based on real-time surgical data while upholding highest standards in safety. In orthopaedics and neurosurgery fields robots need to deal both with soft, deformable tissue as well with hard, rigid tissue. While operating in the vicinity of fragile and critical structures, they may need to display large forces. Maintaining surgical (functional) accuracy in this type of environment remains an open challenge.

Advancing the capabilities of surgical robotics demands interdisciplinary research across multiple fronts. Aside from progress in actuation, sensing, and control, a key challenge is to improve the real-time understanding of the surgical scene to deal with deformation, physiological phenomena and uncertainty. A major focus these days is on developing AI models for real-time decision-making in complex surgical environments, processing data from diverse sensors, and making precise autonomous decisions. As robots gain autonomy, ensuring their reliability through novel control and planning strategy is crucial for handling complex situations without compromising patient safety. Additionally, seamless data integration from visual and non-visual sources is essential for accurate decision-making. Despite increased autonomy, human-machine collaboration and teleoperation remains essential to ensure robustness, safety and efficiency. To this end developments there is a need for intuitive interfaces that enable surgeons to oversee the scene, understand the intentions of autonomous agents, and intervene when necessary.

Our Research Topic welcomes novel work featuring robust technical methodologies that show excellent potential for robotics to advance interventions in the orthopedic and neurosurgical space. We encourage submissions focused on technologies at lower readiness levels, validated through laboratory experiments, user studies, or ex-vivo human/in-vivo animal experiments. Please note that clinical studies are not within the scope of this issue.

We invite submissions that explore the following themes:
- New or existing robotic platforms enabling new interventions or approaches.
- Robotic perception including intraoperative sensing and imaging
- AI-driven control and path planning
- Novel methods for human collaboration with intelligent machines
- Digital Twinning
- Surgical Training
- Translational research
- Future directions including next-generation technology and potential new applications

Topic Editor Tom Vercauteren is the Co-founder and shareholder of Hypervision Surgical. Topic Editor Matthias Harders is the Co-founder and shareholder of VirtaMed AG. Topic Editor Philipp Fürnstahl is the Co-founder and shareholder of X23D AG. The other Topic Editors declare no competing interests with regard to the Research Topic subject.