Ronna Medical: The Robotic System Transforming Neurosurgery

Ronna Medical is an advanced technology company revolutionizing neurosurgery with advanced robotic systems. These robots assist in making surgeries such as biopsies more accurate, safe and efficient. The RONNA (short for Robotic Neuro-Navigation) robotic arm is controlled remotely by the surgeon and is able to make the surgeries more cost-effective and lead to better success rates and shorter recovery times for the patients. 

We travel to Ronna Medical’s headquarters in Zagrab, Croatia to meet co-founder Dr Bojan Sekoranja, a mechanical engineer with a PhD in robotics. He tells us more about the Ronna system and how it could be used in the future on a wide range of different surgeries, not just neurosurgeries, and may one day not even need a surgeon present. 

Find out more about Ronna Medical here. 

Find out more about Windchill here.

Your host is Paul Haimes from industrial software company PTC. 

Episodes are released bi-weekly. Follow us on LinkedIn and X for updates.

This is an 18Sixty production for PTC. Executive producer is Jacqui Cook. Location recording by Will Aspinall. Sound design and editing by Clarissa Maycock. Music by Rowan Bishop.

Transcript

Paul Haimes: [00:00:00] Welcome to Third Angle where we are engineering the future of neurosurgery.

I am your host, Paul Hames from Industrial Software Company PTC. In this podcast, we share the moments where digital transforms physical and meet the brilliant minds behind some of the most innovative products around the world. Each powered by PTC Technology

Ronna Medical is an advanced technology company based in Croatia, which specializes in Med-Tech. Supported by PTC partner, EAG, their mission is to develop robotic systems, which make surgical procedures faster, safer, and more precise. Their flagship product, the Ronna system, short for Robotic Neuronavigation, is designed to [00:01:00] assist neurosurgeons with unprecedented accuracy and control.

Equipped with its own camera and intelligent software, it guides surgeons in procedures such as biopsies. Ronna is designed to improve the success rates and recovery times for patients at lesser costs. Our producer Will Aspenal visits Ronna Medical headquarters in Zagreb to meet co-founder Dr. Boyan Sekoranja, a mechanical engineer with a PhD in robotics. He tells us how he helped take Ronna from a university research lab to real world surgical success.

Bojan: Hi, my name is Bojan. Welcome to Ronna. Ronna was founded as a company in 2021 and this is where our office premises were set up. We are uh, located in Zagreb, Croatia, our laboratories and our, uh, offices are all located here on the [00:02:00] premises, and, uh, we will go now for a brief tour of our environment.

Ronna got its name as an abbreviation for a, uh, Robotic Neuro Navigation. Robotic Neuron Navigation is a process where we use a robot to assist the surgeon in order to be able to do an entire uh, surgery. At this point, Ronna is a non-invasive, uh, device. Ronna is, uh, used as a guide, uh, for the surgeon where he places it, uh, guide in the defined trajectory by the surgeon, and the surgeon uses that guide then to reach the target points of the operation.

Yeah, we can, we can go into the lab where there's a setup of our, uh, robotic platform.[00:03:00] 

Ronna as a system is comprised of multiple, let's say, parts. There's the robot arm itself with seven degrees of, uh, freedom, but, uh, placed on a mobile platform, which is self-propelled and, uh, to a certain extent autonomous. And then we have the supporting, uh, other elements like, uh, planning station that is, uh, set up for itself where the surgeon has the interface to the planning of the entire surgery based on preoperative images on the patient. And we have a patient stabilization device, which ensures, uh, greater stiffness of the system where the patient and we have to have high accuracy of the surgery. So we need to provide additional stiffness.

We are trying to solve multiple problems. Basically, when you have a human, uh, doing something, then the task is always, uh, error prone. So we try to [00:04:00] establish a, a, a safe, uh, working environment when, when even the surgeon does the operation that does that, the operation is relatively safe and very accurate.

Of course, in, uh, current medical practice, the gold standard is using manual frames, which are set up manually, like a set of rulers, which then, uh, guide the surgeon to an exact position. Because using freehand, uh, you wouldn't be able to reach a target point with that error, which is required in neurosurgery.

Human, uh, humans can do very sophisticated tasks, especially a very well trained surgeon, but even they cannot freehand, uh, reach a point in with sub-millimeter accuracy. The, the accuracy has to be, uh, in sub-millimeter range because neurosurgery is the highest standard of accuracy you have to reach because you have to avoid critical, uh, regions, uh, in the brain, which have to stay in text in order [00:05:00] for to maintain proper function. 

Neurosurgery in general is very, uh, very demanding in scope that if you make an error, the person can lose some, uh, function in this, not regarding is it in brain or is it in spine severing a nerve or, uh, damaging a region you can lose, uh, speech, vision or uh, whatever. So you have to be very precise in this.

To, uh, achieve this high precision, we need to develop our own, uh, hardware, our own, uh, solutions because nothing was, uh, ready off the shelf on the market to ensure this high precision that we needed. So that's why we decided to make our proprietary vision system, which we call Ronnavision. It's actually a two camera system with a structured, uh, light with, uh, band pass filters and so on, and an internal, uh, computing unit, which then has software that stands on it, which then calculates everything, [00:06:00] uh, grabs the image, processes, these images, and, uh, relatively high frequencies to, uh, make it as fast as possible.

Uh, Ronna Medical as a company was founded in, uh, 2021, but this is actually just a company. Ronna itself as a concept and as a project is now, uh, even older than a decade. We started research work in 2009. It was a research project done at the University of Zagrab Faculty of Mechanical Engineering in Neuro Architecture because we didn't want to end that it ends like a lot of research projects. When they're over, they end up in the drawer somewhere and they are never heard of again. We saw a lot of, uh, potential in this. Basically, we saw that this, uh, brings benefits, uh, generally into the medical personnel, [00:07:00] to the patients and so on, and we didn't want it to end in a drawer.

That's why we, uh, struggled to find ways to make it a company. And in, we succeeded in that in 2021, Ronna as a company, as a startup was founded and we started employing, uh, people here at the company.

Uh, Ronna is meant to be silent because it's meant to work in a busy, uh, uh, environment of the OR where the focus has to be on the patient and actually following what happens with the patient. It doesn't, it mustn't be allowed to distract the medical personnel from the task at hand. [00:08:00] In the OR the patient is the biggest priority and keeping his vital signs under control and so on. 

The surgeon has to be focused on the surgery itself, not managing the robot with, uh, uh, handling alerts, events, uh, loud beeps, which are distracting and so on. That's why we try to do most work, as much as work as possible, uh, that the system handles autonomously, uh, by itself. That's why we have a lot of, uh, safety measures. That's why we have a lot of self-checks. We do self-checks before the surgery to make sure, uh, in the preparation phase that nothing is going to go wrong in the, uh, operation phase.

Ronna would, uh, be at this point using a variety of neurosurgical applications. Meaning, uh, for example, we already did in clinical trials, uh, [00:09:00] biopsies, but, uh, that's not the limit. We can also do DBS, SEG, even assist on, uh, tumor resection or whatever. So whatever is in cranial space, Ronna can assist with that task. The most simple to explain is the biopsy is when you have some mass, suspected mass, in your brain, which is shown on the imaging. Then you're not sure is this mass, uh, a cancer or a benign tissue or whatever, and the first step is to take a sample of that tissue. And the biopsy is the one, uh, uh, that does it.

The surgeon plans which part of the tissue he would like to take a sample of, and the robot then helps to reach that target point and to extrapolate the tissue for analysis.

Ronna helps reduce the economic burden of, uh, the surgery by shortening the operation time itself, meaning less time under anesthesia, less time, uh, occupying the [00:10:00] operating room and less time occupying the surgeon who is doing the procedure itself. Uh, when you have short time of the, uh, procedure, then you get additional benefits. The patient was less under anesthesia, so his recovery is, uh, better. Uh, elevated precision of the procedure leads to, uh, better clinical outcomes and so on. So this as, as a whole, leads to, uh, leads to a better recovery of the patient, better processing of the patient, and he's, uh, actually reintegration as, uh, individual after the, after the medical intervention.

In the lab we have a lot of, uh, people working. As I mentioned, our, the lab is a center place for integration. So the robotic platform itself is not just the robot arm, it's the entire, uh, it's the entire complex structure of 2000 parts that [00:11:00] all have to be moving, working together. You have a lot of, uh, embedded systems, you have, uh, industrial controllers, you have PCs, you have, uh, cameras, uh, moving parts like motors, shafts and so on, and it all has to come, all has to come together and work, uh, harmoniously in, in one, uh, medical product. There's a lot of things that can go wrong, but that's why you have to do extensive testing and, uh, try everything in the lab.

And that's where we actually have a big, uh, experience even before, uh, starting in medical field, in industrial environments where the robots are working 24/7 without any human uh, uh, presence. You actually have a supervisor that walks around every few hours, but every, he has to work, uh, non-stop. So that's why we incorporate a lot of testing, a lot of, uh, checks, a lot of, um, uh, diagnostics, [00:12:00] which then actually make sure everything is working, uh, as intended.

In 2016, we started clinical trials. Uh, Ronna did its first, uh, biopsy operation on a patient, and from that point on, Ronna successfully did, uh, more than 50, uh, surgeries on, uh, people. We have an idea that Ronna Medical isn't just a robot that's used in neurosurgery. We have an idea that it's an open, uh, platform that can be used for multiple purposes.

Uh, the neurosurgery says, we see as a stepping stone as the first one that we set the benchmark because of the high precision, high uh, accuracy demands. Uh, and if we can do that, we see that we can do a lot of other stuff, especially when you have synergies with other companies producing, uh, target base, uh, tools that can do specific [00:13:00] procedures so they don't have to build it from the ground up because we already did it, but they can focus on their, uh, specific application.

Being in, uh, medical robotics is, uh, challenging but also rewarding because, uh, your work directly translates to something that's going to be beneficial for human health. So that's the very nice notion that you're not working on weapon systems or something that's going to be used for destructive purposes, but, uh, quite the opposite you're you doing something that's going to be used to help, uh, people.

Paul Haimes: That was Dr. Boyan Sekoranja sharing Ronna medical's vision to make precision surgery more accessible and impactful. Now it's time to meet our expert, John Haller from PTC. Hello, John, you're new to The Third Angle, in fact, to PTC as well. Would you first [00:14:00] like to introduce yourself before we talk about Ronna Medical and Windchill?

John Haller: Sure. Uh, my name's John Haller. I am the general manager for PLM here at PTC. I actually was with PTC for a long time, for 12 years. Uh, left for three years to be Chief Revenue Officer at Apriori and have been back for about two months now.

Paul Haimes: Thank you, John. That's great. Ronna Medical are already a user of Creo and have recently deployed Windchill to be its single source of truth.

That term is commonly used. Can you give an overview as to what it means and how it benefits companies such as Ronna Medical? 

John Haller: If we went back 15 years, you would hear PTC people talking about single source of truth with Windchill. So it's been a common theme for us for a really long time. The interesting thing over time is that our MedTech customers have embraced that better than most industries because of the regulatory climate that they live in.

They need to have an integration of business processes across all of design, [00:15:00] across manufacturing, across supply chain, so that they can be in compliance with regulatory requirements around the world and make sure that they can ship products. Uh, what that means is having all your design artifacts in a single place under strict change control so that you can prove beyond a shadow of a doubt that you've done everything possible to produce the highest quality product, to prove that they're in compliance with quality standards around the world.

So what it really means is having good change control of all your quality processes and, uh, having all your design artifacts in a single place so that you can reuse those across all of those submissions that must be completed to get your product out faster and at, uh, better quality and cost.

Paul Haimes: Thanks to John and to Dr. Bojan and our producer Will for taking us behind the scenes of Ronna Medical. Please rate, review and subscribe to our biweekly Third Angle episodes wherever you listen to your [00:16:00] podcasts and follow PTC on LinkedIn and X for future episodes. Companies that make products the world relies on rely on PTC.

This is an 18Sixty production for PTC. Executive Producer is Jacqui Cook. Location recording by Will Aspenal. Sound design and editing by Clarissa Maycock. A Music by Rowan Bishop.