On 3 July 2019, the world's first maxillary correction using robot-controlled laser ablation took place at the University Hospital Basel (USB). For the first time, the incision of a human bone was carried out by laser-supported robotic technology instead of the usual surgical instruments, such as a saw or a drill - a medical sensation.
Cold Ablation Robot-guided Laser Osteotomes
CARLO® is the world's first medical, tactile robot that can cut bone without contact and autonomously with cold laser technology. The innovation is a development of the Basel medical technology start-up "Advanced Osteotomy Tools - AOT AG".
AOT was founded in 2010 by Dr. Alfredo Bruno, Prof. Philippe Cattin, Prof. Hans-Florian Zeilhofer of the Hightech Research Center of the USB and Prof. Philipp Jürgens, Senior Physician of Oral and Maxillofacial Surgery at the USB. Each of the four founders brought substantial knowledge in the disciplines of laser physics, robotics and bone surgery to the company.
AOT launched the first-in-man CARLO® study in Basel in collaboration with the research group led by PD Dr. Andreas Müller, Senior Physician for oral and maxillofacial surgery at the USB, and the Department of Clinical Research (DKF). Meanwhile, other successful transoral midface osteotomies using contactless robot-assisted surgery have been performed in Basel and Vienna, respectively. The fourth use of CARLO® is again planned at the USB. The study is intended to demonstrate the safety and performance of the CARLO® device and serve as the basis for its CE certification and, consequently, for its market launch in Europe.
The clinical testing of a medical device has become complex. However, it is important that we can be actively involved in shaping the transfer of innovative surgical techniques. The DKF team has proven to be a reliable research partner for this undertaking.PD Dr. Andreas Müller, Oral and maxillofacial surgery at USB
First successful deployments
Silke Purschke, Study Nurse at the DKF, accompanies Andreas Müller's research team into the operating theatre. She documents that all operations during the procedure are carried out accurately and strictrly according to the protocol. She also coordinates and documents the follow-up visits with the treated patients. It is crucial to know how the healing process progresses for the individual study participants after the use of CARLO®. For Andreas Müller and his team, the first-in-man study is also an instructive and interesting experience.
It is impressive to experience the possibilites of innovative technology in the field of surgery close up.Silke Purschke, Study Nurse at the DKF
AOT revolutionises bone surgery with CARLO®
The CARLO® contactless laser technology makes it possible to completely digitise the entire process from preoperative planning to incision. Cutting jigs or special instruments are no longer necessary. In addition, laser technology ensures the safe use of robotics for osteotomies, since the cutting instrument, the laser, can be removed immediately and safely at the speed of light in case of erratic patient movements. CARLO® only cuts when the patient and the robot are synchronised. Another advantage of the new technology is the ability to execute freely defined cutting patterns, which allows for new and gentler surgical techniques. This should accelerate the bone healing process, as seen in promising results from preclinical studies.
The laser can be used universally on the entire body. Similar to a smartphone, the technology enables the upload of applications that support the physician in the complete implementation of the intervention. One initial app has been developed by AOT for the indication "maxillary correction". Further indications will follow. Upon successful study completion and approval, the device would be marketed internationally.