Evidence map›Paper›PMID 42294811›Full record

ArticleThe international journal of medical robotics + computer assisted surgery : MRCAS2026

Robotic Intraoperative Imaging in Orthopaedic and Trauma Surgery: Initial Clinical Experience With a Self-Driving Mobile 3D C-Arm in the First 300 Cases.

Benno Bullert, Luca Ruebel, Jula Gierse, Eric Mandelka, Fenna Brunken, Paul A Gruetzner, Sven Y Vetter

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Article in The international journal of medical robotics + computer assisted surgery : MRCAS, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Benno BullertBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwigshafen, Germany.ORCID https://orcid.org/0009-0003-3539-4839
Luca RuebelBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwigshafen, Germany.
Jula GierseBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwigshafen, Germany.ORCID https://orcid.org/0000-0002-3955-0339
Eric MandelkaBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwigshafen, Germany.ORCID https://orcid.org/0000-0002-7337-2783
Fenna BrunkenBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwigshafen, Germany.ORCID https://orcid.org/0009-0007-8113-3786
Paul A GruetznerBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwigshafen, Germany.ORCID https://orcid.org/0000-0002-0730-4782
Sven Y VetterBG Klinik Ludwigshafen, Department for Orthopaedics and Trauma Surgery at Heidelberg University, Ludwigshafen, Germany.ORCID https://orcid.org/0000-0001-8024-9276

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntraoperative C-arm imaging is essential in orthopaedic and trauma surgery, particularly with the increasing use of minimally invasive techniques. Conventional repositioning is performed by non-scrubbed staff, while robotic imaging systems are mainly limited to hybrid operating rooms. This study presents the first clinical experience with a fully motorised, self-driving mobile 3D-C-arm.

methodsIn this prospective, single-center study, 300 procedures were analyzed using device log data and perioperative parameters to assess imaging workflow and system performance.

resultsOf 300 procedures, 279 were included. Mean procedure time was 104.7 ± 57.4 min, with a C-arm operation time of 31.9 ± 29.1 min, corresponding to a C-arm operation ratio (COR) of 35.2%. Automated positioning accounted for 30.7% of movements, and 37.9% of images were acquired from stored positions.

conclusionThe system enabled sterile-field control and demonstrated potential to support intraoperative imaging workflow. Further comparative studies are required to evaluate its clinical impact.

Indexed as

Imaging, Three-DimensionalOrthopedic ProceduresRobotic Surgical ProceduresWounds and InjuriesAdultAgedFemaleHumansMiddle AgedOperative TimeProspective StudiesSurgery, Computer-AssistedWorkflow3D‐C‐armC‐arm repositioningintraoperative imagingrobotic imaging

Identifiers

PMID42294811
PMCPMC13267478

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.