I'm working on a system that helps surgeons make precise bone cuts during knee replacement surgery. Believe it or not, manual cuts are still the standard in that type of procedure. Robotic systems exist but they are very costly, big, and actually add time to the surgery (bad news when you are under anesthesia and your leg is in a tourniquet).

It uses 4k stereoscopic capture and bunch of ML models to match bone position with sub-millimeter precision. The surgeon screws a metal base piece into the bone, and we detect where that is in space. Then, a Stewart Platform adjusts another part that is placed onto the base. The robotic adjustment allows the base to be placed in a ballpark area, with the robotically-adjusted piece oriented in the exact spot where the surgeon needs to cut.

The net result is a robotic system that is many times cheaper than the least expensive incumbent, decreases surgery time significantly, reduces error, and basically "just works" as opposed to requiring a ton of training. We are debuting at a tradeshow in October.

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nyantaro1 3 days ago | parent | next [-]

This sounds awesome! Can you tell me more about what kind of expertise do you need to develop such a system? As in the most important knowledge one most have to be able to work on such a thing

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stevepotter 2 days ago | parent [-]

Thanks, buddy! I'm having fun. There are a few sides to it. There are the actual physical surgical tools that you have to design, test, and manufacture. Then there's the robot that adjusts those tools. That stuff is a lot of CAD and 3D printing. The camera is a big deal and it's a ton of work to get that right. Then of course you have all the software, which is a slew of computer vision models that operate on a local computer in a careful dance of resource orchestration. The software has a lot: UI, grpc services, ml models on containers, inverse kinematics for calculating robot position, hardware interfaces, etc. Then there's a bunch of regulatory, validation, compliance, etc.

To answer your question about expertise, it really depends on what you are interested in. We have some dedicated mechanical engineers with medical device experience. The software is handled by a few computer vision and full stack folks. So there's different skillsets.

I'm a bit of a journeyman and as a result, I am decent across all of it. I always did software and went where the wind blew. It's been 20-something years since I graduated so I've seen a lot. About 10 years ago I got a job I was totally unqualified for, which was R&D for a company that made lab equipment for testing gas and oil. I was solo and had to learn all the mechatronics stuff - CAD, microcontrollers, electronics, etc. Check out this video: https://youtu.be/MA6hnyXx4p4. That specific experience allows me to be the glue in our engineering org.

To work here, you don't need medical experience. We have plenty of that. One of the cool things about engineering, especially software engineering, is that you can float around between verticals. I've learned all about media, finance, petroleum, insurance, waste disposal, etc. The skills translate. If you are purely software, I recommend picking up an Arduino and some motors and building something like a simple pan/tilt mechanism with an accompanying mobile app. Just do it. It might inspire you. I think curiosity and enthusiasm are the most valuable traits one can have.

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nyantaro1 2 days ago | parent [-]

That seems like a long journey. I think playing with Arduino is a perfect way to get started on the interaction between software-hardware. Thanks a lot for your answer!

	▲	stevepotter 2 days ago \| parent [-]
		Building something that combines software and hardware is so rewarding. Reach out to me if you have questions - steve at redefinesurgery.com

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linsomniac 2 days ago | parent | prev | next [-]

So a Shaper Origin for bone cutting? Pretty neat!

	▲	stevepotter 2 days ago \| parent [-]
		Great analogy!

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mentos 3 days ago | parent | prev [-]

Curious if you’ve heard of OssoVR and what your honest assessment of VR training in your field is?

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stevepotter 2 days ago | parent [-]

VR training hasn't really stuck in ortho training. It's legit and people do it, but it's a distant second to doing it live. I haven't seen that much of it, but from what I have seen, the fidelity is quite low. It would be cool to see what a good game studio could produce.

Doctors, like most people, don't like stuff on their head. Plus in ortho there is a lot of feel to it. It's often referred to as "carpentry". The docs I know, especially those with experience, would prefer a video and a cadaver lab. Even that's a lot to ask because they are so swamped. In every surgery there is a rep from the implant company, and those reps are really the ones doing the training.

So there is certainly potential but it's just not to the point where people are excited about it.

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conductr 2 days ago | parent [-]

Used to work for a major implant company, we had a cadaver lab at company headquarters and flew in doctors for training. The rep in the OR is mostly just for support. They carry in a bunch of hardware in case the doctor needs to pivot midway through, they may need different sized screws or something. They can show doctors how the device is meant to connect together without bone/tissue but they often have little to no medical training, they are sales representatives.

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stevepotter 2 days ago | parent [-]

Hey there, thanks for writing. For those who don't know, the sales reps have to carry in racks and racks of parts. Most go unused but the last thing you want is something to go wrong and not have the piece you need readily available.

I've been in many different ORs and I've found that the rep's knowledge and level of participation varies a lot. Some of these reps have been working with the same products for years, the doc fully trusts them, and could probably perform the procedure themselves. Others not so much.

	▲	conductr 2 days ago \| parent [-]
		This sounds about right. My time in the industry, I always remember our top selling rep was basically royalty at the company he drove so much volume - but, he was only about 22 and never finished college or had any actual medical training. He just grew up with a surgeon Dad, country club, etc. and had deep connections with a lot of surgeons by virtue of this. He was also very charismatic and a good salesman, just not the guy you'd want training your surgeon before they fused your spine.