Abstract: Objective To explore the surgical strategies, techniques and precautions of robot-assisted minimally invasive surgery for pelvic ring injuries. Methods The clinical data of 108 cases of pelvic ring injuries treated with robot-assisted minimally invasive surgery were reviewed. There were 71 male and 37 female, average age was 41.6 years(range, 21-79 years), including 6 cases of isolated anterior pelvic ring injuries and 102 cases of combined anterior and posterior pelvic ring injuries. The surgical plans were formulated based on the type and degree of injuries, effectiveness of the reduction, and integrity of the osseous channel. The surgical complications and efficacy were recorded. Results Percutaneous cannulated screw fixation of the pubic ramus was performed in 6 patients with isolated anterior pelvic ring injuries. Percutaneous cannulated sacroiliac screw fixation and open screw or plate fixation of the symphysis pubis was performed in 7 patients with posterior pelvic ring injuries combined with symphysis pubis separation. Percutaneous cannulated 山 东 大 学 学 报 (医 学 版)57卷11期 -刘华水,等.骨科手术机器人辅助微创治疗骨盆环损伤108例临床分析 \=-sacroiliac screw and pubic ramus screw fixation was performed in 40 patients with posterior pelvic ring injury combined with unilateral anterior pelvic ring injury. For the 55 patients with posterior pelvic ring injury combined with bilateral anterior pelvic ring injury, cannulated screw fixation alone was performed in 14 cases, INFIX fixation in 24 cases, and “hybrid surgery” in 17 cases. A total of 344 screws were inserted with robotic assistance, of which 326 were successfully inserted to a satisfactory position on the first attempt. The average operation time was 106 minutes. Fluoroscopies were performed with an average of 29.2 times, and it took 6.1 s to place one screw. There were 18 unsatisfactory guiding needle placements during the surgeries, 6 of which remained in the bone tunnel and were not re-planned, 7 cut out, 4 penetrated the cortex and were re-planned to satisfactory position, 1 penetrated the pubic cortex, causing hemorrhage of the “crown of death” and was changed to “hybrid surgery”. During the follow-up of 4.2 months, 2 fixation failures were observed, and the average Majeed score was 89.4 points. Conclusion Robot-assisted surgery provides a novel modality for the minimally invasive treatment of pelvic ring injuries when the surgical strategy is properly formulated and surgeons have good techniques.

Key words: Pelvis, Fracture internal fixation, Robotics, Surgery, Minimally invasive surgery