A Chinese University of Hong Kong medical team completed Hong Kong’s first robot-assisted minimally invasive surgery to reduce and fix a pelvic fracture in June, and had carried out three such operations by August 21, according to reports.
The procedure uses a three-dimensional CT scan for planning before surgery. During the operation, a robotic arm and real-time three-dimensional navigation data help surgeons reposition and fix the fracture inside the body.
Reported blood loss during the operations was about 10 to 20 millilitres. The team said conventional open surgery can involve blood loss of 1 litre or more, while Ming Pao reported that the team said the robotic procedure reduced blood loss by nearly 90 per cent. The reported comparison basis and calculation were not detailed.
Ming Pao reported that conventional surgery can leave wounds longer than 10cm, while the new technique can reduce the minimally invasive incision to less than 2cm. The report said the patients recovered well after surgery, but did not provide individual patient details or longer-term follow-up information.
Pelvic fractures are challenging because of the complexity of the pelvis and its proximity to major nerves and blood vessels. Hong Kong has about 2,000 pelvic fragility fractures each year, according to the reports. Frail older people who cannot withstand major surgery may receive conservative treatment and remain bedridden, facing risks including pneumonia, pressure sores and venous thrombosis.
The team said the technique is more difficult to use for patients with fractures on both sides of the pelvis. It may also be harder to perform when more than two weeks have passed and the bone has begun to heal. The reports did not give the procedure’s cost, operating time, suitability rate or long-term outcomes.