In May this year, Dr Werner van der Merwe, an orthopaedic surgeon at Mediclinic Bloemfontein, performed his 500th Mako Robotic-Assisted Knee Replacement surgery.

Having performed computer-assisted surgery from as far back as 2009, orthopaedic surgeon Dr van der Merwe describes the transition to robotic-assisted work as a natural progression. “Computer-assisted, or image-guided surgery, was almost like using a passive robot,” he explains. This approach helps surgeons plan bone cuts by using instruments attached to the patient’s body to provide feedback. This feedback then informs the surgeon’s actions.

But new, robotic-assisted surgery amplifies the advantages offered by this technique, he says: “If computer-assisted surgery is like Google Maps, then robotic-assisted surgery can be compared to a self-driving car. The precision and predictability of this technique are far superior, and patients generally enjoy better outcomes.”

Dr Van der Merwe explains that several different types of robotic surgery have been developed over the past three decades; each offering different benefits that make it suited to different types of surgery. Mako Robotic-Arm Assisted Surgery is best for knee replacements because the software is used to devise a three-dimensional surgical plan before the surgery, while the device’s robotic arm carries out this plan very precisely during the knee replacement. This removes the potential for human error.

How robotic-assisted surgery works

Almost one million knee replacement surgeries take place in the United States every year, according to the Oregon-based Center Orthopedic and Neurosurgical Research. This explains the rising interest in Mako Robotic-Assisted Knee Replacement, especially in patients with knee pain or osteoarthritis.

The first step in such a surgery is to create a 3D model of the patient’s knee. This is done using a CT scan, so the surgeon has an accurate presentation of the anatomy and can plan and tailor the surgery considering the individual’s unique structure.

This plan is used as a “map” once surgery is underway and is overlaid on the real-time operation. The surgical instruments are held by both the robotic arm and the surgeon, although they remain under the surgeon’s control.

One of the key benefits to this type of surgery is that the “tracking eyes” of the robot allow adjustments to be made easily should any micro-movements of the knee occur. This allows for more appropriate alignment of the new joint.

More benefits

Mako technology ensures greater personalisation, which translates into precise placement of the implant. The surgeon also maintains control over all aspects of the surgery at all times, and receives real-time sensory feedback – again, allowing greater precision.

Obviously, from the surgeon’s point of view, the benefits are significant. “Although the cost and time involved in robotic surgery are often deterrents, our team has reached a point where we’re able to complete procedures quickly,” Dr Van der Merwe says. His team usually complete between four and 10 procedures every week.

Massive benefits exist for patients, too. Comparing patients of say, five years ago, to those who’ve undergone robotic-assisted surgery, Dr van der Merwe says the latter group experience far less pain and a quicker recovery time. “Most returning for their six-week check-up seem to feel a great deal more comfortable. They also allow less time to elapse before returning for the second knee replacement.”

Patients are able to walk hours after their procedure, and in some cases, recovery is almost complete after six weeks. Dr Van der Merwe’s extensive expertise in this area ensures he and his team at Mediclinic Bloemfontein can offer patients the very best, most advanced treatment.