What is Robotic Surgery in Orthopaedics?

Robotic surgery in orthopedics does not mean the robot is doing the whole surgery, rather surgeon takes the help of a robotic arm to increase the precision of bone preparation, tissue balancing and placement of implant.

How is robotic surgery being done?

In robotic surgery surgeons creates a virtual 3D real time image of bone with the help of
i) computed tomography,
ii) real time information relay regarding position and movement of the limb and
iii) finally a robotic arm with sensory feedback to prepare bone surface and placement of implant.

What Orthopedic surgery is being done with robots?

Most common orthopedic surgeries done with robotic assistance are TKR and UKR. The journey of robotic surgery has been started with these two surgeries. Currently robotic surgery is also available for THR and spine surgery and the future is waiting for many other surgical procedures to be possible with robotic assistance like arthroscopic knee and shoulder surgery?

Benefits of Robotic Surgery?

• Every patient is unique in their anatomical variation. With robotic surgery surgeons can ensure precise and accurate alignment, tissue balancing following surgery by accurate sizing of implant and precise minimum resection of bone.
• Surgery can be done with minimum dissection as surgeons need not to see the joint wide open because sensory feedback enables the robotic arm. Which ensures protection of sensitive tissues from the dangerous cutting instrument. Sensory feedback arm works only where there is bone, and it stops working if it goes beyond the cutting area thus preventing damaging essential structures around the knee like ligaments that maintains joint stability and blood vessels around the joint thus protects the limb.
• Blood loss is minimum and tissue recovery is faster as the surgical dissection is less.
• Surgeons can reproduce the same surgical outcome for every surgery due to the precision of calculation of bone defect deformity and tissue tension with the help of real time communication by high-speed communication array between surgical field and computer and true patient specific 3D image of the bone. Margins of error and deviation from standards become very less.

Is there any risk or disadvantage of robotic surgery?

• Possibility of fracture from the pin insertion point for the communication array. Which can be avoided by placing the pins near the metaphyseal to avoid any stress point at diaphysis.
• Need a CT scan, an extra investigation and radiation exposure.
• Procedure becomes costlier.