HEALTH SENSE: Robotics assisted surgery for joint replacement

HEALTH SENSE

Robotics-assisted technology improves precision and outcomes for Alaska’s joint replacement surgery patients

By Dr. Tucker Drury

Not long ago, joint replacement surgery required a hospital stay. But medical advances in recent years have improved and streamlined the procedure, enabling many patients to have a knee or hip replaced in an outpatient facility and go home the same day.

Now an innovation, robotics-assisted technology, makes that outpatient procedure even more precise, so patients spend less time in surgery and have a quicker recovery and a new joint that fits and performs better that ever.

My partners and I at Surgery Center of Wasilla, a multi-specialty outpatient facility serving Alaska’s Mat-Su Valley, recently became the first ambulatory surgery center, or ASC, in Alaska to invest in robotics-assisted technology.

We all had used the technology in the hospital, and we are especially excited to now bring it to our ASC.

Why? Because it improves patient outcomes dramatically, and in addition to better accuracy, it helps us shorten the patients’ intraoperative experience.

Surgery Center of Wasilla’s roboticsassisted system is very robust, with five surgeons currently using the technology. The system is built on years of data and experience and allows us, as surgeons, to build a customized preoperative plan for each patient.

As a first step, the patient obtains a CAT scan of either their hip or their knee, preoperatively. We then take that three-dimensional model into a planning session where we really look at their unique anatomy, and if the patient has issues such as deformities from an arthritis pattern that has gone on for a long time, we can anticipate those problems. Once in the operating room, we again collect data points from the patient’s anatomy and reconcile what we see with our preoperative plan – so we have checks and balances. And then we engage the assistance of our system’s robotic arm as a tool to make the needed surgical cuts very precisely and with confidence that we’re doing everything in the best way possible to make this mechanical joint work really well – ideally, as well as the patient’s original joint.

One of the questions I often get from patients is, “Is the robot going to do my whole surgery?” And the answer is no.

As the surgeon, I still have to make the incision and treat the tissues with respect and provide really good exposure. But with the robotic arm, I have an advanced tool making me better, blending technology with my experience to create a great outcome for the patient.

For patients, one significant advantage of the new system is fewer cuts and smaller incisions. Traditionally, total joint replacements used X-rays, two-dimensional technology, to create the preoperative plan for a patient. But oftentimes with that flat, traditional

As the surgeon, I still have to make the incision and treat the tissues with respect and provide really good exposure. But with the robotic arm, I have an advanced tool making me better, blending technology with my experience to create a great outcome for the patient.

approach, you’d get into the operating room, make a cut and check it, and then you’d have to cut again, because while the plan was two dimensional, we’re dealing with a very complex, threedimensional joint. I have personally found that the new technology improves the plan so much that I cut less, reducing potential trauma to the patient. With the robot, we assess, plan, observe, and then we cut. And that is also what really shortens the intraoperative experience.

In addition, the robot helps ensure the new joint is being put in proper alignment, which makes a big difference in its usability. Think of it like aligning a

set of new snow tires up here in Alaska: If we put them on crooked, the wear pattern is going to be inappropriate, and they won’t last as long. With roboticsassisted technology, I have a tool that can help me align the patient’s parts better to increase longevity.

The robotics system we now have in place at Surgery Center of Wasilla comes from Stryker, a manufacturer with a long track record of success with hip and knee implant products. The Stryker Mako System lets us marry successful implants with the cutting-edge technology that helps us put them in with more precision and better outcomes for the patient. It’s humbling to admit, but I have carefully studied my results and have realized that using a tool like this makes me a better surgeon – the pieces get put in better with the assistance of this technology.

My advice for patients who are candidates for joint replacement? Do the research, look up Stryker online, and take a look at the Stryker Mako robot. Outpatient total joint replacement has become the standard of care in the Lower 48, and demand is expected

to increase exponentially in the next decade. The reason is, for a patient who is healthy and motivated, the less time they spend in the hospital environment for a procedure like this, the better. This is especially true in today’s environment of the coronavirus. If you’re not in a hospital where you can be exposed to patients with other disease processes, and if we can get you back to your home environment faster, where you’re with the people who love you and your own food and your own TV, that’s often a big win.

Dr. Tucker Drury is a surgeon-owner at Surgery Center of Wasilla. He has completed more than 170 knee and 140 hip replacement surgeries using robotics-assisted technology.