Robots performing surgery may seem futuristic, like something from Star Trek or Star Wars. In reality, robots such as Mako are fast becoming assistants in the operating room. This technology offers unparalleled precision and accuracy in performing surgery, but must still be controlled by a surgeon with years of experience and training.
Here’s how it works :
Mapping out the human body
In the weeks ahead of a scheduled knee joint replacement surgery, we will obtain a CT scan of the leg.
A motion rod is placed next to the patient for accuracy. A specialized protocol for the CT scan is used to ensure the lowest possible amount of radiation is used. Typically this is in the region of 0.4mSv (1 chest Xray = 0.1 mSv).
The CT scan data is loaded into the Mako software. 3D virtual bone models and planning images are created. The surgeon can then use this data to pre-plan the implant sizes and position before even stepping into the operating room.
The Mako robot is spatially aware, meaning it knows where each part of the knee is in relation to everything else. It recognizes key landmarks from the CT scan. The surgeon will identify these landmarks during the registration part of the surgery, and the Mako will lock its sensors onto them. Once this is done, the Mako will know where every part of the bone is during the surgery, even if they move!
This spatial awareness allows the surgeon objectively measure the effects of soft tissue releases or osteophyte removal in real time. Minute adjustments to the implant positions and cuts can then be made to optimize fit and soft tissue tension for each individual knee.
Matching the pre-planned surgery to the live environment is what makes Mako so useful. The surgeon uses the robotic arm as an extension of his own arm. It allows him to guide the cutting instruments into precise position before making the bone cuts. The robotic arm also allows the surgeon to countercheck that the prosthetic implants are cemented in exactly the correct location that was planned for.
Even without robot assistance, we can achieve excellent results. Robotic arm assistance simply pushes results beyond what we’ve been able to expect in the past. Higher accuracy means the replacement fits as well as it possibly can and ensures the joint functions as normally as possible after surgery.
For patients, it’s been shown to result in shorter hospital stay, quicker recovery and higher satisfaction. There’s also strong evidence of decreased pain and complications following surgery.