May 30, 2024

Robotic surgery is forged as surgery executed with the aid of computer navigation or a robot.

The robot is derived from the Polish word ‘robota‘ which means ‘forced labor’

A machine that carries varieties of tasks automatically or with a minimum external impulse, especially one that is programmable

Robotic Surgery

Types of Robotic Surgery

  1. The haptic or tactile system
  2. Autonomous System
The haptic or tactile systemAutonomous
Requires constant input by the surgeon for the procedure to proceedThe surgeon performs the approach and set up the machine
Uses 3D-CT to recreate the patient kneeBut once engaged, the robots complete the surgery with/ without the surgeon’s help
The surgeon uses this model pre-operatively to plan the sizing and placement of the componentThe surgeon is in control of the emergency cut-off switch while robots operate independently
Intraoperatively, the surgeon will reference the bony surface of the femur and tibia allowing the preoperative model to be merged with the actual anatomy of the knee
Advantages:
1. Small incisions, 2. Shorter recovery and rehabilitation time, 3. Fewer complications

Passive surgery system (Computer navigation in orthopedics)

  • Monitor progress and provide surgeons with data during the procedure
  • Used preoperatively
    • To assess joint irregularities and joint biomechanics
    • To make recommendations to continue with the procedure
    • To make the accuracy of bone cuts

Limitations

  • Costly
  • Requires frequent system upgrade
  • More study is needed
  • Autonomous system – Increase incidence of infection and nerve damage

Patient-specific Instrument: Advantages and Pitfalls

PSI aims to improve the accuracy of TKR based on computer-assisted preoperative planning, as few degrees of malalignment can lead to failure

Conventional arthroplasty procedures have a high success rate, however, they involve several technical steps (sizing, alignments, rotations then bone cutting) which are dependent on each other

Patient-specific jigs and related technology are adopted by surgeons with the intensions to replace conventional TKR and computer navigation

It improves the accuracy of implant sizing and positioning, saving time and improving overall outcomes

Advantages

  1. Patellar kinematics
  2. Soft tissue balancing
  3. Accuracy in saggital and coronal plane

Disadvantages

  1. Costly
  2. Increase radiation
  3. Surgeon learning curve
  4. Lack of verification tools
  5. Increase waiting time for the procedure

See also: NanoTechnology in orthopedics

See also: Bioabsorbable Polymers