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Robotic Spine Surgery

Robotic Spine Surgery

The future is now

Reading Time: 3 minutes

Robots have been working for us for the past 50 years. They have been used in industrial applications such as automobile manufacturing doing some of the more dangerous and repetitive work such as welding or lifting heavy car parts. In fact, the Tesla automotive plants have a  significant amount of robots therefore speeding production and decreasing costs. Robotic application in healthcare especially in surgery is a more recent event. Robots are increasing being used in varied way in surgery. They are very helpful since they can lead to increased precision in performing delicate surgeries.

 

Perhaps the best know surgical robot is the DaVinci surgical robot. This robot is used as an extension of the surgeon in performing very delicate surgeries in the abdomen and pelvis. In this application, the robot is positioned over the patient and the surgeon sits in a console and remotely control the robot. In this console the surgeon is able to view what the robot is doing through specialized cameras which are inserted in the patient’s body. Since the robot can work through very small incisions called portals the surgical trauma to the patients body is minimized leading to less surgical pain and a faster recovery for the patient.

 

This kind of robotic use is very different from the robots used in manufacturing. The DaVinci robot is not automated meaning it does not operate independently with a set of instructions like the robots in the Telsa plant or the robots in an Amazon warehouse. The DaVinci robot is more an extension of the surgeons hands and is controlled at all times by the surgeon.

 

The robots used in spinal surgery is a hybrid of the independent robots used in the automotive plants (Telsa, GM, Ford) or in the Amazon warehouse and the DaVinci. The spinal surgery robot is semi-autonomous in that it can carry out some pre-determined instructions and then act as an extension of the surgeon’s hands.

 

Spine surgery often includes placing specialized instruments into the spine while avoid causing injuries to the spine and the nerves which are in it. Some of these specialized instruments or implants are meant to provide support for the spine and required very precise placement.

With the spinal robots such as the Mazor or Excelsius GPS very detailed images of the spine from a CT scan is fed into the robot. These images are then used as a guide for the robot to navigate around the spine and allows the robot to find the best path or location to place these specialized instrumentations into the spine. When the robot is doing this it is acting semi-autonomous based on the set of instructions that the surgeon programs into the robot. Once the robot finds the best route to place the  instrumentations it then becomes a guide to help the surgeon in placing the instrumentations.  The surgeon then uses the robot’s guide to place a portal or small incision in the skin above the spine and uses this same portal to place the instrumentations. In this role the robot is acting as an extension of the surgeon in the same way the DaVinci robot does.

In spinal surgery, the current benefits of the robot are:

  • to decrease the time of surgery since it can find the best and quickest way to place instrumentation
  • decrease the size of the surgical incision and therefore the post op pain since the surgeon can now work through the very small incisions.

This is only the beginning. In the future, we can envision spine surgery being done completely by robots based a surgical plan that the surgeon creates. In those scenario, there will be  significant benefits to the patients since the surgery will be done faster, with better surgical precision and with less surgical morbidity leading to a faster recovery for the patients.

 

 

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Dr. Spine

Board Certified, Fellowship Trained Spine Surgeon

Dwight S. Tyndall, MD, FAAOS

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