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As a neurosurgeon, engineer and entrepreneur, Victor Yang, M.D., Ph.D., PEng, feels a duty to ensure that the clinical needs of his fellow physicians are met. After SeaSpine acquired Dr. Yang’s 7D Surgical navigation system in 2021, he began working on a robotic system that he believes solves the limitations of current enabling technology on the market. That work transpired into 8i Robotics, a company seeking to commercialize a next-generation, active robot for the spine market.
8i Robotics developed a multi-arm robot and an end-to-end integrated system that eliminates the need for multiple pieces of equipment in the operating room. The head of the robot hovers over the patient and serves as the eyes for the surgeon while the right arm serves as a high-torque, high-precision screwdriver and the left arm an ultrasonic bone cutter. It’s also multimodal, offering intraoperative navigation and imaging.
The company is currently co-marketing the robot with Implanet, but the system is open and will be compatible with any spine implant once it receives regulatory clearance.
“Obviously, this is the next level of robotic assistance,” Dr. Yang said. “It’s innovative and the updates are clinically relevant.”
We spoke with Dr. Yang about the robot’s features and why they’re necessary.
What’s significant about 8i’s robot?
Dr. Yang: The surgical robots that use optics for navigation constantly lose navigation due to line-of-sight issues. We want to solve that problem. Also, every time I use navigation or a robot in the operating room, I still bring in a microscope for decompression or a C-arm for imaging — the equipment competes for a footprint.
Everything that a spine surgeon will need is in this one platform — a microscope, navigation system, power screw insertion system, light source, ultrasonic magnet — and everything is fully integrated and works together.
What’s the significance of the two arms?
Dr. Yang: The arms can simultaneously make a pilot hole for the pedicle using the ultrasonic knife and the other is putting in the screw. A human surgeon cannot do two things at the same time. Your left hand and right hand cannot work on different parts of the spine, but the robotic surgeon can.
What is the role of the surgeon with your robot?
Dr. Yang: The surgeon needs to supervise the surgery. I think of the robot as a very accurate spine fellow. He does exactly what I tell him to do, but I’m always watching during the case. With our robot, the surgeon keeps their foot on the pedal to operate the system and watches the robot to make sure it’s doing exactly what it needs to do. If it’s not doing what I want it to do, I hold the robot’s arm and it stops.
How does the robot decrease a surgeon’s cognitive load or decision-making?
Dr. Yang: We need cognitive load reduction. This system requires surgeons to plan the surgery in advance. I tell my fellows to perform the surgery according to the plan so that in the operating room, they can focus on important things like decompression, soft tissue and nerves.
Have you found that surgeons are more willing to use pre-planning tools today than in the past?
Dr. Yang: I have mixed feelings about planning. 7D Surgical uses the concept of plan on the fly because it aligns with surgeons’ experiences. This system is next-level technology, though, and we would like surgeons to pre-plan their cases to improve safety and patient care. We also recognize that a pitfall of robotic surgery is that pre-op planning doesn’t always match intraoperative circumstances. Our system includes a feature to plan on the fly. We want surgeons to be able to modify the plan during the case if necessary.
What obstacles did you have to overcome to build this system?
Dr. Yang: Line of sight and accuracy were the primary pain points. We reduced the human factor to make more repeatable procedures. We’re starting clinical trials soon and will gain insights to improve the consistency of our outcomes.
What does your commercialization pathway look like?
Dr. Yang: Our regulatory submission is pending. We are collecting user feedback. Here at NASS, we have three different robots demonstrating different functions, and we want to get input from surgeons to see what they like and what they don’t need.
I expect to receive clearance in less than a year. We know that our friends and competitors are releasing new robots, too.
As a neurosurgeon, engineer and entrepreneur, Victor Yang, M.D., Ph.D., PEng, feels a duty to ensure that the clinical needs of his fellow physicians are met. After SeaSpine acquired Dr. Yang’s D Surgical navigation system in 2021, he began working on a robotic system that he believes solves the limitations of current enabling technology...
As a neurosurgeon, engineer and entrepreneur, Victor Yang, M.D., Ph.D., PEng, feels a duty to ensure that the clinical needs of his fellow physicians are met. After SeaSpine acquired Dr. Yang’s 7D Surgical navigation system in 2021, he began working on a robotic system that he believes solves the limitations of current enabling technology on the market. That work transpired into 8i Robotics, a company seeking to commercialize a next-generation, active robot for the spine market.
8i Robotics developed a multi-arm robot and an end-to-end integrated system that eliminates the need for multiple pieces of equipment in the operating room. The head of the robot hovers over the patient and serves as the eyes for the surgeon while the right arm serves as a high-torque, high-precision screwdriver and the left arm an ultrasonic bone cutter. It’s also multimodal, offering intraoperative navigation and imaging.
The company is currently co-marketing the robot with Implanet, but the system is open and will be compatible with any spine implant once it receives regulatory clearance.
“Obviously, this is the next level of robotic assistance,” Dr. Yang said. “It’s innovative and the updates are clinically relevant.”
We spoke with Dr. Yang about the robot’s features and why they’re necessary.
What’s significant about 8i’s robot?
Dr. Yang: The surgical robots that use optics for navigation constantly lose navigation due to line-of-sight issues. We want to solve that problem. Also, every time I use navigation or a robot in the operating room, I still bring in a microscope for decompression or a C-arm for imaging — the equipment competes for a footprint.
Everything that a spine surgeon will need is in this one platform — a microscope, navigation system, power screw insertion system, light source, ultrasonic magnet — and everything is fully integrated and works together.
What’s the significance of the two arms?
Dr. Yang: The arms can simultaneously make a pilot hole for the pedicle using the ultrasonic knife and the other is putting in the screw. A human surgeon cannot do two things at the same time. Your left hand and right hand cannot work on different parts of the spine, but the robotic surgeon can.
What is the role of the surgeon with your robot?
Dr. Yang: The surgeon needs to supervise the surgery. I think of the robot as a very accurate spine fellow. He does exactly what I tell him to do, but I’m always watching during the case. With our robot, the surgeon keeps their foot on the pedal to operate the system and watches the robot to make sure it’s doing exactly what it needs to do. If it’s not doing what I want it to do, I hold the robot’s arm and it stops.
How does the robot decrease a surgeon’s cognitive load or decision-making?
Dr. Yang: We need cognitive load reduction. This system requires surgeons to plan the surgery in advance. I tell my fellows to perform the surgery according to the plan so that in the operating room, they can focus on important things like decompression, soft tissue and nerves.
Have you found that surgeons are more willing to use pre-planning tools today than in the past?
Dr. Yang: I have mixed feelings about planning. 7D Surgical uses the concept of plan on the fly because it aligns with surgeons’ experiences. This system is next-level technology, though, and we would like surgeons to pre-plan their cases to improve safety and patient care. We also recognize that a pitfall of robotic surgery is that pre-op planning doesn’t always match intraoperative circumstances. Our system includes a feature to plan on the fly. We want surgeons to be able to modify the plan during the case if necessary.
What obstacles did you have to overcome to build this system?
Dr. Yang: Line of sight and accuracy were the primary pain points. We reduced the human factor to make more repeatable procedures. We’re starting clinical trials soon and will gain insights to improve the consistency of our outcomes.
What does your commercialization pathway look like?
Dr. Yang: Our regulatory submission is pending. We are collecting user feedback. Here at NASS, we have three different robots demonstrating different functions, and we want to get input from surgeons to see what they like and what they don’t need.
I expect to receive clearance in less than a year. We know that our friends and competitors are releasing new robots, too.
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Carolyn LaWell is ORTHOWORLD's Chief Content Officer. She joined ORTHOWORLD in 2012 to oversee its editorial and industry education. She previously served in editor roles at B2B magazines and newspapers.
