Spine surgery sounds like a big deal. But once it has to be carried out of necessity, patients only wish that their doctors could perform the most effective operation to alleviate their suffering with the smallest wounds, quickest healing and speediest recovery possible.
Now such a wish is a dream come true, thanks to a new minimally invasive spine-surgery technique offering precise screw placement using a robotic arm to assist surgeons during the screw-insertion procedure.
Generally, 80-90% of patients undergoing spine surgery suffer from degenerative diseases of the spine. Although technology enables people to live longer, it means more people face spine degeneration as they age. However, ageing is not the only cause; younger people who have high body weight and certain lifestyle traits can also be vulnerable to degeneration of the spine.
The new surgery technique is ideal for adolescent idiopathic scoliosis (a type of spinal deformity), multiple-level lumbar degenerative disease, and fractured vertebrae. The robotic arm is also useful in cases of patients facing anatomical challenges.
The robots' forte is to enable surgeons to utilise minimally invasive surgery techniques with a guided robotic arm. The rigid robotic arm navigates the best instrument trajectory with extreme precision.
"The reason the surgical wound is small is because the robotic arm focuses at the precise co-ordinates where screws are to be placed," said CEO and medical director of Bumrungrad International Hospital, Assoc Prof Dr Somsak Chaovisitsaree.
"The robotic arm has six joints, making it very flexible and dexterous in accessing small areas without needing to make a big incision and can insert the screws with high precision."
However, this kind of surgery does not rely only on the robotic arm that helps determine co-ordinates for precise screw placement, but also on the experience and the expertise of the surgeons to place the screws safely.
Dr Somsak explained that, in this case, the role of the doctors is still significant.
"The robotic arm is a technology that complements surgeons' work, not to replace it. It enables surgeons to focus even more on delicate parts of spine surgery such as in spinal-decompression surgery."
He added that specialists are continuously trained, raising their skill levels and becoming increasingly familiar and comfortable with controlling the robotic tool.
In an operating theatre, approximately eight to 10 surgeons and medical specialists are involved in the process. Such a number is no different to spinal-surgery procedures without using robots. However, using a robotic arm means the set-up takes about half-an-hour longer, with the doctors programming and controlling the robots at every stage.
After obtaining 3D spinal images, the surgeon plans and designs the spinal construction procedure using computer software before commencing to operate. The robot is synced with the patient through a reference point attached to the patient's spine. The surgeon verifies that all information matches precisely before starting the surgery.
During surgery, the robotic arm moves as directed by the surgeon, adjusting the position of its arm according to the programmed screw trajectory. Rigidity of the robot arm also assists the surgeon in inserting the screw with extreme precision. "It's undeniable that there are risks in every surgery," admitted Dr Somsak. "But utilising these technologies is proving very effective in minimising as much risk as possible."
