Will robots rule the world? perhaps.
But now that I’m watching someone have orthopedic surgery, it’s not scary, it’s fascinating.
Scrubbed clean and masked, Sky News was invited to watch a robotic arm-assisted total knee replacement at Walsall Manor Hospital.
This is the first time such technology has been used in an NHS regional general hospital, with clinical director Thomas Moores leading the ground-breaking procedure today.
“Is it nerve-wracking to prepare for this?” I asked him before the procedure.
“Well, it’s exciting,” he said.
“The robotics help us plan ahead, so the surgery itself is actually much less stressful.”
Today’s patient is Jess Sansara in her 60s.
He suffers from severe arthritis in his right knee, and for months, the pain was so painful that he couldn’t walk.
“We used to offer an 18-week wait,” but now there’s a “one to two-year backlog”
“Patients have had to wait too long for their joint replacement,” Mr Moores said.
“We used to offer an 18-week wait. Unfortunately, COVID has put us on a backlog of one to two years.”
That’s where doctors hope robotic-assisted surgery can help (if you’re not comfortable with saws, bones, or surgery, you might want to skip to the end).
First, the preparation is different.
Using robotics, a 3D computer image of the joint is made before surgery.
The part of the deformed bone that needs to be removed is marked on this image.
These parts need to be removed before a new artificial knee can be fitted.
The robotic arm is mounted on a large mobile platform and pushed next to the operating table.
The “hand” end of the robotic arm is securely attached to the orthopedic bone saw that will be used in the surgery.
The surgeon also holds the saw and can start and stop it.
Now, this is where planning comes in.
small margin of error
Now turn on the saw, and the surgeon starts cutting the bone, guided by the robotic arm.
The robot’s sensors limit the movement of the surgeon’s saw, restricting any bone cuts beyond the planned resection marked on the 3D image.
The margin of error is small.
If the surgeon deviates from the marked area by more than half a millimeter, the robot automatically stops the saw.
We see it doing this as Mr. Morse – surrounded by robots and human colleagues – comes into play.
In front of the surgical team is a large computer screen showing a 3D image of Mr. Sansara’s right knee.
The real-time movement of the saw is tracked on the screen, which also indicates the lines the saw should not cross.
“It means every day is the best day in surgery”
Granted, on the rare occasion Mr. Morse crosses those lines, the screen flashes red and the robot steps in and shuts down the saw instantly.
“With robotic assistance, it really means that every day is the best day in surgery,” Mr. Moores said.[and] It’s really safe for the patient, less soft tissue damage for some, better bone preservation for others. “
In the words of patients, this could mean less pain and a faster recovery.
For hospitals, this means being able to free up beds more quickly.
“Early evidence suggests it may translate into shortened length [patient] stay,” said Fahad Hossain, the hospital’s director of research and development.
“The quicker we can get patients out, the quicker we can get in patients who are waiting longer.”
“This surgery is the future for all patients”
But, unsurprisingly, the technology doesn’t come cheap.
The hospital’s trust has invested £1.8m here, using grants earmarked for innovation.
At a time when NHS spending and staff wages are under intense scrutiny, the relatively narrow range of equipment being used for hip and knee replacement procedures is huge.
But its proponents argue that it could help relieve pressure on health services almost immediately.
“A lot of the pressure comes from the bottleneck of patients in hospital beds,” Mr Hussain said.
“We’re really proud to be bringing this technology to the community here for use in NHS regional hospitals.
“Typically this would be the domain of the private sector, but we believe this is the future of this type of surgery for all patients.”
“Better Patient Outcomes”
About two hours after receiving general anesthesia, Mr Sansara’s operation was complete.
He has had a new artificial knee fitted, his mobility appears to be good and he is recovering.
“If he passes all of our physical assessments, we’ll be sending him home tomorrow afternoon,” Mr. Moores said. We find better patient outcomes.”
The next morning, a message from the hospital let us know that Mr. Sansara was up and doing well.
Forget people and machines: this robot is here to help.