Although it had been theorized for decades that laser technology has the potential for superior osteotomies, it required the invention of a new Erbium:YAG laser to finally make Laser Osteotomy achievable. The laser pulse heats the water content of the bone in a fraction of a second, vapourizing it without heating the surrounding bone. The volumetric change and resulting kinetic energy fracture the bone structure on a microscopic level, and the excess energy ejects the debris.
The CARLO® laser is focused to a sub-millimetric width, producing extremely sharp cuts. Combined with the ability to perfectly follow planned trajectories with robotic navigation, this means that outstanding precision is achievable every time, for every patient. The surgeon is able to expertly plan and simulate multiple cut paths pre-operatively, and then have CARLO® autonomously execute the selected osteotomies. Alternative trajectories can be defined or adjusted at any time during the procedure, and depth analyses serve to protect the underlying tissue by providing critical safety information to the surgeon.
We have developed a laser that cuts bone without causing carbonization, inflammation, or necrosis on the cutting surface. CT scans, SEM imaging, and histological analyses all show that the laser leaves a porous, vascularized structure that can remineralise faster. Mechanical instruments like piezo tools leave behind a smear layer by forcing bone debris into the healthy tissue. This layer inhibits perfusion and needs to be resorbed before bone can regrow, delaying the healing process.
While carpenters have been using functional cuts for centuries, surgeons have always been limited to straight or slightly curved paths by their instruments. Laser Osteotomy will change that with limitless custom shapes and interconnecting cut surfaces. In this way, the bone segments can slot together like a puzzle for optimized primary stability. The fixation requirements for osteosynthesis are therefore reduced, and less rigid plate systems, including bioresorbable options, can be used. The larger contact surface and preserved bone structure at the osteotomy edge further facilitate an improved healing process.
With autonomous and contact-free robot guided lasers we aim to replace cutting templates and robotic tool holders. The potential to finally overcome the risks and limitations of mechanical tools and the human hand alike will open the door to the fully digitized and autonomous operating room of the future.