Three KIMA arms on a single cart: how metamorphosis designed its system with NVIDIA Isaac for Healthcare, in silico then in the real world.

Building a multi-arm surgical robot means designing an environment and workflows that fit several arms, an imaging system, and a surgical team into the same limited space. Metamorphosis, a trackerless surgical navigation company based in Paderborn, Germany, mounted three KIMA arms on one mobile cart for an investigational pelvic fracture prototype, and shaped the layout first in a virtual operating room built with NVIDIA Isaac for Healthcare.

How do you fit a multi-arm surgical robot around the patient and the C-arm?

In pelvic fracture surgery, bone fragments must be repositioned and held, instruments guided along planned trajectories, and the C-arm positioned for every verification view. Each extra arm usually brings its own controller, power supply, and footprint. Many existing orthopedic surgical robotic platforms use a single arm, primarily for instrument positioning and guidance, while more complex workflows can benefit from multiple arms working together. This case study shows how metamorphosis took a multi-arm approach with Kinova’s KIMA robotic arms, and iterated on the layout in simulation before components were manufactured.

Inside the case study: why three KIMA arms instead of one

• Why three arms instead of one: two for fracture reduction, one for trajectory guidance
• Why a mobile cart originally designed for one industrial arm now holds three KIMA arms
• How one shared controller and force-torque sensing at the flange simplified integration
• How metamorphosis tested cart placement, reach, and imaging access in NVIDIA Isaac for Healthcare
• Why simulation let developers build and test control, perception, and workflow logic before the complete physical system existed
• The development loop from virtual operating room to anatomy lab

For teams building surgical robotic systems

• R&D and engineering leads at medical device companies building surgical robotic systems
• Robotics engineers evaluating medical robotic arms for OEM integration
• Product managers planning a multi-arm system for a constrained operating room
• Clinical innovation teams exploring simulation-first development

“KIMA's compact arms and small mounting footprint enabled configurations that we had not been able to realize with other medical OEM arms we had considered.”

Arno Blau, CTO, metamorphosis

“Our role is to give medical device innovators a robotic platform they can build on, so they can focus on what makes their system unique.”

François Boucher, Strategic Growth VP, Kinova

Questions about KIMA in multi-arm surgical systems

Can several Kinova KIMA arms share one controller? Yes. Up to four Kinova KIMA robotic arms can be daisy-chained to a single controller, which reduces the space needed for controllers and power supplies inside a surgical cart.

Are Kinova KIMA arms available in NVIDIA Isaac for Healthcare? Yes. 3D models of the Kinova KIMA arms are openly available as sim-ready OpenUSD assets in NVIDIA Isaac for Healthcare, so medical device teams can place KIMA arms in a virtual operating room before building hardware.

How did metamorphosis use Kinova KIMA arms in its surgical prototype? Metamorphosis, a trackerless surgical navigation company based in Paderborn, Germany, built an investigational three-arm prototype for pelvic fracture surgery in which two Kinova KIMA arms assist fracture reduction and a third KIMA arm positions a guide sleeve along a planned trajectory.

Why design a surgical robot in simulation first? In the metamorphosis case study, simulating robotic motion, camera imaging, and X-ray imaging in a single virtual environment built with NVIDIA Isaac for Healthcare let the team explore complex surgical workflows before building physical prototypes. Developers could also start building and testing control, perception, and workflow logic before the complete physical system existed.

Is the metamorphosis three-arm system approved for clinical use? No. The metamorphosis three-arm robotic system built with Kinova KIMA arms is an investigational prototype: it is not cleared or approved by the U.S. FDA, not approved for clinical use, and not available for commercial sale in any jurisdiction.