Dr. Pedro Roldán Ramos
Neurosurgeon · Robotic spine and functional surgery
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Precision technology
Robotic surgery
Robotic arm integrated with neuronavigation and preoperative 3D planning. Submillimetric precision in pedicle screw placement, deep electrodes and complex surgical trajectories.
What is it?
The robot-assisted surgical arm
Robotic surgery does not replace the surgeon: it assists them. Based on a prior 3D surgical plan, the robotic arm guides instruments with precision unachievable freehand. The neurosurgeon maintains full control at all times and can correct the trajectory in real time.
Applications
- Instrumented spine surgery: robotic placement of pedicle screws with submillimetric precision.
- DBS and deep electrode implantation: trajectory from the scalp to the target nucleus with minimal deviation.
- Stereotactic biopsies: access to deep lesions reducing the risk of damage to adjacent structures.
- SEEG (electrodes for epilepsy monitoring): multi-electrode implantation guided by robot.
Key advantage: reducing inter-operator variability. What separates a good surgery from an excellent one is often the consistency of each step. The robot provides that consistency to a technique already mastered by the surgeon.
How it is done
Step by step of a robot-assisted procedure (ALAYA)
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1 · Preoperative imaging
High-resolution CT and/or MRI of the segment to be operated. For the spine, CT is used; for the brain, it is fused with functional MRI or DTI tractography when eloquent areas are nearby.
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2 · 3D planning
3D reconstruction of the segment. The surgeon draws each trajectory (pedicle screws, electrodes, biopsy) on the model and the software verifies that they respect cortical boundaries, vessels and neural structures.
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3 · Intraoperative registration
In the operating theatre, a 2D/3D intraoperative CT is performed. The tracking system (bone reference clamp in ALAYA, without optical cameras) aligns the preoperative map with the patient's real anatomy in real time.
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4 · Arm guidance
The robotic arm is automatically positioned at each planned trajectory with ±0.3 mm precision. The surgeon inserts the instrument through the robotic guide, maintaining manual control of pressure and depth.
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5 · Verification
Intraoperative radiological check (CT or fluoroscopy) to confirm correct positioning of each implant before completing the surgery.
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6 · Radiation reduction
The robotic guide allows a significant reduction in fluoroscopy during surgery, resulting in less exposure for the patient and surgical team compared to the conventional technique.
Surgical technology
Robot-assisted surgery with ALAYA
We use the ALAYA Robotic Assistant (Cyber Surgery) for the precise placement of pedicle screws in spinal fusion surgery, both open and minimally invasive.
ALAYA guides the trajectory of the surgical instruments through a patented kinematic tracking system that requires no optical navigation cameras: it avoids the classic line-of-sight problems and takes up less space in theatre. The patient's position is monitored in real time by a bone reference clamp attached directly to the tracking device, which improves the overall accuracy of the procedure.
What do we use it for?
- Pedicle screw placement in the posterior thoracic and sacro-lumbar spine.
- Spinal fusion surgery, both open and minimally invasive.
- Intraoperative 3D planning using preoperative or intraoperative 2D/3D CT.
- Implant-brand independence: compatible with any commercially available cannulated screw.
A real benefit for the patient: a reduction in mean hospital stay from 9.4 to 6.8 days documented with robotic assistance in spinal fusion, together with lower intraoperative radiation exposure for both patient and team.
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Greater accuracy
Significantly more accurate pedicle screw placement than with conventional technique.
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Minimally invasive
Less tissue damage, lower risk of infection and faster postoperative recovery.
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Shorter operating time
An intuitive workflow and fast set-up that shorten the length of the procedure.
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Lower radiation
The system minimises the number of image acquisitions needed during surgery.
Our specialists
Neurosurgeons who operate with robotic assistance
Dr. Jhon A. Hoyos Castro
Neurosurgeon · Instrumented spine and robotic vertebral fusion
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Dra. María Elena Filadoro
Neurosurgeon · Minimally invasive spine with robotic assistance
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Patient reviews
What our patients say
High-grade glioma
"I arrived with a glioma I had been told was inoperable. Here they reviewed it at the tumour board and offered me a plan. The surgery was a success. Four years on, I am well."
Cervical disc herniation
"For years I had a cervical disc herniation, operated on by another team with no improvement. Minimally invasive surgery gave me back my mobility and took the pain away."
International patient
"I travelled from outside Spain. The team reviewed my case before I came and gave me a clear plan. Caring people and impeccable technique."
Request information
Does your case benefit from robotic assistance?
We send your case to the committee to decide the optimal technique.