ROBOTIC SURGERY

By Dato’ Teddric Jon Mohr, MHA, FACHE

There are many types of Robots in medicine today. Some will automatically take your blood pressure as you walk around, automatically inject insulin for diabetic, shock the heart to keep it beating, move your arms or legs and the list is growing.

Robotic surgery is advancing very quickly.  The Robots entered the areas of knee replacement surgery in 2006. One of the new leaders in robotic surgery is StrykerMako. This device allows the replacement of the Knees either fully or partially. The robotic arm technology, (Whole Arm Manipulator “WAM”) was developed by MIT and Barrett Technology.

The human knee of bones, muscles and ligaments are very complex.  The replacement by a metal joint assures the patient that he can walk or run with less pain.  Therefore, computers have been used for years along with x-rays to make sure the length and alignment of the metal knee is accurate.  However greater accuracy appears to be now available with a Robot.

The StykerMako RIO system using a CT x-ray to create 3D model of the patient’s knee assisting the surgeons to develop a plan that prepares the for the implant, the size needed, alignment and positioning.  This customized plan is used to assist during surgery with the added placement of pins in the leg then integrated with the 3D CT and real time views guiding the surgeon during surgery.  The real time information increases the accuracy giving greater safety for an ideal implant positioning which reduces potential complications.

Studies on the MAKOplasty patients using randomized controlled trials show the patients experience less pain days after surgery than those that underwent manual surgery after two months.  Other studies on the partial knee replacement have shown the robot is 2-3 times more accurate than manual techniques.  Interim results of patients indicate the robotic arm has a 0.4% failure rate versus a 4.0% rate for manual implants.

From partial knees in 2006 to full knees in 2015 over 23,000 MAKOplasty procedures have been preformed using the robot.  There are now over 150 hospitals worldwide using the Robotic system. 

As with ALL new medical interventions evaluation over time is the key.  To date with thousands of knees replaced there seems to be an advantage in robotic knee surgery with less pain and quicker return to normal life in the Unicompartmental Knee Arthroplasty (UKA).

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