Robotic Intraoperative Imaging in Orthopaedic and Trauma Surgery: Initial Clinical Experience With a Self‐Driving Mobile 3D C‐Arm in the First 300 Cases

BACKGROUND: Intraoperative C-arm imaging is essential in orthopaedic and trauma surgery, particularly with the increasing use of minimally invasive techniques. Conventional repositioning is performed by non-scrubbed staff, while robotic imaging systems are mainly limited to hybrid operating rooms. This study presents the first clinical experience with a fully motorised, self-driving mobile 3D-C-arm. METHODS: In this prospective, single-center study, 300 procedures were analyzed using device log data and perioperative parameters to assess imaging workflow and system performance. RESULTS: Of 300 procedures, 279 were included. Mean procedure time was 104.7 ± 57.4 min, with a C-arm operation time of 31.9 ± 29.1 min, corresponding to a C-arm operation ratio (COR) of 35.2%. Automated positioning accounted for 30.7% of movements, and 37.9% of images were acquired from stored positions. CONCLUSION: The system enabled sterile-field control and demonstrated potential to support intraoperative imaging workflow. Further comparative studies are required to evaluate its clinical impact.