1 2 S U P P L E M E N T T O O U T P A T I E N T S U R G E R Y M A G A Z I N E A P R I L 2 0 1 7
the operative plan
identifies as "green;" if
the surgeon moves 1
mm outside of that
green zone, the robotic
arm alerts the surgeon
by turning the area red
on the system's dis-
play. If the surgeon
moves the arm 2 mm
outside of the safe
area, the arm turns off. "It's like a scratch-off ticket," says Dr. Nonweiler. "You
can only remove the areas that you're allowed to."
The other option employs a smart handheld instrument, says Victor Khabie,
MD, FAAOS, FACS, chief of the department of surgical services at Northern
Westchester (N.Y.) Hospital and co-director of the hospital's Orthopedic and
Spine Institute. Surgeons input the patient's joint measurements into the sys-
tem's computer intraoperatively and use the information to create an operative
plan. The instrument helps guide the surgeon as he makes his cuts, says Dr.
Khabie. If he doesn't follow the operative plan, the instrument automatically
shuts off.
These robotic orthopedic systems are a step above previous computer naviga-
tion programs, which helped doctors plan surgical cuts pre-operatively. "It's
based on the same idea of using a 3D model to tell you how to best position the
implant and where to make optimal cuts," says Dr. Khabie. "But the beauty of
the current technology is that once you lock the operative plan into the comput-
er, the system controls the burr and only allows you to shave off areas targeted
in the pre-op plan."
Robotic platforms rely on precise calculations and real-time information on
how the joint moves, so they provide huge improvements in the accuracy of
• PLAN OF ATTACK Robotic systems guide surgeons through surgery and alert them when
they've gone off course.
Northern
Westchester
Hospital
