New Frontiers

MDR Clearance for CARLO®

We have obtained CE approval under the MDR for the second generation of our surgical laser robot CARLO!

The world’s first bone cutting laser now covers a broader range of indications and is approved for interventions 𝘁𝗵𝗿𝗼𝘂𝗴𝗵𝗼𝘂𝘁 𝗺𝗮𝘅𝗶𝗹𝗹𝗼𝗳𝗮𝗰𝗶𝗮𝗹 (MF).

CARLO’s new generation also enables surgeons to monitor the cutting progress more closely than ever before thanks to 𝗢𝗖𝗧-𝗯𝗮𝘀𝗲𝗱 𝗱𝗲𝗽𝘁𝗵 visualization and 𝗺𝗶𝗰𝗿𝗼𝘀𝗰𝗼𝗽𝗶𝗰 𝘃𝗶𝗲𝘄 enhanced via coaxial lighting.

In addition, surgeons can define risk zones in which laser pulses are limited automatically, to 𝗽𝗿𝗼𝘁𝗲𝗰𝘁 𝗰𝗿𝗶𝘁𝗶𝗰𝗮𝗹 𝘀𝘁𝗿𝘂𝗰𝘁𝘂𝗿𝗲𝘀 like the nervus mandibularis.

We are proud of the entire AOT team for achieving this milestone that allows us to bring the unique benefits of laser bone surgery to patients across Europe.

CARLO® - Potential for Neuro & ENT surgery

We have investigated a variety of 𝐧𝐞𝐮𝐫𝐨𝐬𝐮𝐫𝐠𝐢𝐜𝐚𝐥 𝐚𝐧𝐝 𝐄𝐍𝐓 𝐢𝐧𝐝𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬 preclinically with CARLO. The precise navigation will allow 𝐟𝐫𝐚𝐦𝐞-𝐟𝐫𝐞𝐞 𝐩𝐥𝐚𝐜𝐞𝐦𝐞𝐧𝐭 of guiding channels for electrodes, biopsy needles or endoscopic access. Unlike other robotic neurosurgical systems CARLO can accurately create a 𝐜𝐡𝐚𝐧𝐧𝐞𝐥 𝐚𝐭 𝐚𝐧𝐲 𝐠𝐢𝐯𝐞𝐧 𝐚𝐧𝐠𝐥𝐞 offering additional flexibility and safety. CARLO allows segmentation of critical areas and can thus 𝐢𝐧𝐜𝐫𝐞𝐚𝐬𝐞 𝐭𝐡𝐞 𝐬𝐚𝐟𝐞𝐭𝐲 of difficult procedures – such as creating channels for cochlear implants or endoscope access for middle ear and also skull base procedures. This could enable 𝐡𝐢𝐠𝐡𝐞𝐫 𝐬𝐭𝐚𝐧𝐝𝐚𝐫𝐝𝐢𝐳𝐚𝐭𝐢𝐨𝐧 𝐚𝐧𝐝 𝐛𝐞𝐭𝐭𝐞𝐫 𝐨𝐮𝐭𝐜𝐨𝐦𝐞 for complex procedures. CARLO can cut any desired shape and will offer hands-free approach or 𝐭𝐞𝐦𝐩𝐥𝐚𝐭𝐢𝐧𝐠 𝐟𝐨𝐫 𝐜𝐨𝐦𝐩𝐥𝐞𝐱 𝐜𝐫𝐚𝐧𝐢𝐨𝐭𝐨𝐦𝐢𝐞𝐬 𝐚𝐧𝐝 𝐜𝐫𝐚𝐧𝐢𝐨𝐬𝐲𝐧𝐨𝐬𝐭𝐨𝐬𝐢𝐬 in the future.

Depth Fine Tuning of Knee Cartilage with CARLO®

We call it reverse 3D printing: CARLO’s cold ablation technology has the potential to improve orthopedic procedures by removing bone or cartilage volumes of any shape for a better fit of existing implants or entirely new anatomical implant concepts. µCT analysis shows that CARLO can produce smoother surfaces and sharper edges, causing less thermal trauma and microdamage compared to mechanical tools, resulting in balanced force distribution and enhanced implant-to-bone contact. 

Q&A with our new and former chairman

We have asked Erich Platzer, our long-term chairman, and Heinz Jacqui, his successor, about opportunities and challenges of the past, present and future of AOT. From acquiring the CE mark for the world’s first Laser Osteotome to the potential for full digitalization of the OR – Jacqui and Platzer give insides into our company’s journey.

CARLO® in Denmark

The first Laser Bone Surgeries in Denmark went down successfully at the University Hospital of Aarhus. AOT thanks Sven Erik Nørholt, Jytte Buhl and Jan Wolff from the maxillofacial department for their great work!

As you can see below, Danish TV was also there.

CARLO meets Brigitte Macron

Famous company for CARLO: Brigitte Macron, First Lady of France, got to know our laser osteotome during her recent visit to the Institut Faire Faces in Amiens. We are proud that CARLO is part of this unique facility that Prof. Devauchelle, Prof. Testelin, Prof. Dakpé and Dr. Bettoni have built up with so much energy and innovative strength!

LIBS Publication

CARLO® will significantly improve surgical treatment for bone cancer patients, thanks to our ongoing development of LIBS (Laser Induced Breakdown Spectroscopy).

It would be the first method to safely identify tumorous bone cells in real time during surgery and enable surgeons to exactly determine which tissue to remove. Hence, with LIBS they could improve the chances of survival for their patients while at the same time preserving their quality of life as much as possible.

AOT already filed a patent for this technology and now the first publication is available at nature.com.

AOT is Ready for Growth

In the past months, the AOT executive team has changed our strategy to faster access the market. As a leading force AOT will strengthen the new category of contact-free and autonomous laser robots.

Study: CARLO for Neurosurgery

“Frontiers in Robotics and AI” published a new study showing the technical and clinical feasibility of executing keyhole access to the brain with CARLO. In collaboration with AOT a group of neurosurgeons of the Vienna General Hospital created more than 70 high precision bone channels with three different angulations by using a newly developed cutting strategy.

Based on this breakthrough AOT continues to explore the clinical potential and benefits of CARLO’s robot-guided cold laser ablation in the human skull. More studies will follow to confirm the clinical evidence in neurosurgery and ultimately to increase the well-being of patients.

100 Clinical Cases

100 patients have already been treated with CARLO. Up to this point, it has been CMF patients exclusively, but we are working hard every day to expand the indications that can be addressed with laser bone surgery. Not just because CARLO can cut any bone in the body, but also because we at AOT are ready for more… way more!

Pilot Study: CARLO in hand, wrist and forearm surgery

After conducting a first pilot study of CARLO in the field of hand-, wrist- and forearm surgery Philipp Honigmann et al. published their findings in The International Journal of Medical Robotics and Computer Assisted Surgery. They conclude:

“Cold ablation laser osteotomy seems to be a feasible new method to perform osteotomies in the field of hand-, wrist- and forearm surgery. Primary osseous stability could be achieved using various cutting patterns which could lead to reduction of the amount of hardware required for osteosynthesis. […]”

Welcome, Heinz Jacqui!

Jacqui, the newest member on AOT’s board of directors, can draw on knowledge and experience gained over 30 years as a manager in the MedTech industry. Among the many companies for which he has held, and in some cases still holds, senior positions are Distalmotion, Intersurgical, Diametos, Draeger Medical, Olympus Surgical and Getinge/Maquet.

“CARLO is a perfect example of why it is so exciting to work in MedTech: different technologies, such as the laser and robotics, are coming together to guarantee an unprecedented quality of treatment for today’s patients”, says Jacqui, “For that reason alone, I’m delighted to support AOT on its way up!”

Heinz Jacqui replaces Peter Burckhardt, who has been part of AOT’s board from the beginning and served as its vice president. We thank Peter for his brilliant support over the past years and wish him all the best!

Innovation for CARLO by AOT & Zühlke

We partnered with the innovation service provider Zühlke to develop a machine learning platform that allows CARLO to determine the progress of its cuts by analysing images with computer vision and artificial intelligence in real-time during surgery. Zühlke provided us with the necessary knowledge and resources to realise this project within our ambitious timeline as well as to make the new technology compliant with the Medical Device Regulation.

Where to find us - Expos 2022

Advancements and Innovations in Surgery

Loews Coronado Bay Resort, San Diego 

Foyer

May 13-14 2022

ISSH, IFSHT & FESSH Combined Congress

ExCel, London

Booth 52

June 6-10 2022

CARLO at Institut Fair Faces

CARLO is now part of the newly opened Institut Fair Faces in Amiens, France. This unique center for research and education will develop new diagnostic and therapeutic approaches to restore form and function to faces disfigured due to congenital malformation, trauma or tumor.

We are proud that the institute decided that CARLO is to be part of this fascinating endeavour and wish success to Prof. Bernard Devauchelle and Prof. Sylvie Testelin who created the institute following their groundbreaking achievements like the world’s first face transplant.

A CARLO patient story

When Paolo Lodise had to undergo jaw surgery, he found out that the intervention could also be done with robotic laser osteotomy. So, he asked his doctor Prof. Christoph Kunz from the university hospital Basel, who then carried out the operation with CARLO.

First CARLO surgeries in France

Our Laser Osteotome made its way into yet another country: In April 2022 at CHU Amiens-Picardie four patients were treated with CARLO, benefitting from its unique advantages. As usual, all surgeries went smoothly.

 

AOT would like to thank Prof. Sylvie Testelin, Prof. Bernard Devauchelle, Dr. Jerémie Bettoni and Prof. Stéphanie Dakpé for the great collaboration!

CARLO® on TV

As Switzerland remains the country with the most patent applications per capita in the world, TV station SRF 1 decided to show AOT as a prime example of Swiss ingenuity on their show “10 vor 10”. This gave us the opportunity to showcase CARLO’s patented skills on national television.

Elmar Zurbriggen (CEO) and Peter Oprandi (CFO) join AOT

We are delighted to welcome Elmar Zurbriggen, our new CEO, and Peter Oprandi, our new CFO, to the AOT team!

Scrub Nurse Testimonial

Marion Jahn, a scrub nurse with decades of experience, has been involved in most of the CARLO procedures at the Paracelsus clinic in Munich. She tells about her hands-on impression of the world’s first Laser Osteotome.

Hand & Wrist & Forearm Surgeries with CARLO

Functional cuts and the outstanding precision of CARLO reveal new possibilities in hand, wrist and forearm surgery. Together with scientists from the Hand Surgery Unit of the Kantonsspital Baselland and the Swiss MAM Research Group of the Department of Biomedical Engineering | University of Basel, we are currently conducting preclinical trials for various indications with promising results.

This image is not part of the cited study, but shows CARLO creating canals in a sheep skull.

Study: "[...] lasers might minimize the invasiveness of navigated brain biopsies"

A new study, published in “Frontiers in Oncology”, finds that “high precision bone cutting by Er: YAG lasers might minimize the invasiveness of navigated brain biopsies”. Using CARLO, the authors* created multiple canals in human skull bone, that were precise enough to guide biopsy needles with sufficient accuracy. They conclude: “Laser technology might be a valuable tool to improve the procedure of brain biopsies regarding invasiveness, procedure time and finally risk profile.”
 
*Thanh Tu Ha, Florian M. Thieringer, Martin Bammerlin and Dominik Cordier

Patient specific cutting path in Le Fort I Osteotomy

Being able to modify cutting paths according to the needs of each individual patient is one of the big advantages of CARLO, the world’s first Laser Osteotome. In October 2021 a cutting path specifically designed for the patient was used in a Le Fort I Osteotomy performed by Christoph Kunz, Hans-Florian Zeilhofer and Florian M. Thieringer at the University Hospital Basel.

LIBS and its potential for cancer surgery

With laser technology you can not only cut bones but also analyze tissue. While in theory this has been known for a long time, AOT is the first implementing it in the praxis.

CARLO in the OR

AOT’s co-founder Prof. Dr. Dr. Philipp Jürgens and his team at the Paracelsus clinic in Munich routinely use laser bone surgery for orthognathic corrections. They have succesfully treated dozens of patients suffering from jaw misalignments with CARLO since the beginning of clinical laser bone surgery in 2021.