04. July 2019

“Cold” laser ablation replaces conventional saws and drills

After around eight years of development and extensive studies and testing, yesterday (3 July 2019) the world’s first corrective surgery of the upper jaw using robot-guided cold laser ablation was carried out at University Hospital Basel. The laser technology, which is an integral part of the CARLO® system, will not only increase safety levels and lead to faster healing for patients, but is also suitable for universal use in a digital operating theatre environment.


Nowadays, a wide range of digital devices and robotic systems form part of the standard equipment of operating theatres. Most of these systems either position conventional mechanical instruments using a robot or convert the movements of the surgeon into movements of the instrument by means of a joystick. The CARLO® system developed in Basel takes a different approach. The acronym CARLO® stands for “Cold Ablation Robot-Guided Laser Osteotome”. CARLO® is the world’s first tactile medical robot that can cut bones using a non-contact cold laser process.

The system created by the medical technology start-up company Advanced Osteotomy Tools AG (AOT), which is based in Basel, is a platform consisting of a navigation unit and a robot that guides the laser osteotome. The laser and the system are suitable for universal use and enable apps similar to those on a smartphone to be installed. These provide surgeons with digital support throughout the surgical process, from pre-operative planning to intra-operative implementation. AOT has already developed the first app of this kind for the indication “corrective surgery of the upper jaw” and it has now been successfully used for the first time at University Hospital Basel. “Contactless laser osteotomy is the digital key to robotic surgery,” explains Cyrill Bätscher, CEO of AOT.

“This first-in-man use of the system, which digitises the entire intervention, reinforces University Hospital Basel’s claim to be a leading player in the digitisation of medicine,” says hospital director Dr Werner Kübler. The first-in-man study, which is currently underway at University Hospital Basel, Cantonal Hospital Aarau and Vienna General Hospital, is part of the European approval process for the CARLO® system.

Laser osteotomy is considered to have significant potential. AOT is now working on real-time tissue analyses. These will ensure that surgeons know at all times whether they are operating on healthy or cancerous tissue. “Lasers not only have safety advantages over conventional instruments. In addition, pre-clinical studies have shown that they lead to a faster healing process and that functional bone cuts can be made to allow for new and less invasive operating techniques,” explains Professor Philipp Jürgens, an oral and maxillofacial surgeon at University Hospital Basel and co-founder of AOT.

Lasers can be used throughout the body. After the study and the approval process for the device have been successfully completed, it will be commercialised for worldwide use.