Although robotic surgery was first approved by the FDA back in 2000, it took time for surgeons to embrace the technology. But embrace it they did, and today robots are a common sight in American operating rooms, including those at Monument Health.
In September 2018, Rapid City Hospital began using the newest da Vinci Xi robots, made by Intuitive, for all types of abdominal and chest procedures. The hospital now has two Xi systems. And soon, orthopedic surgeons at Spearfish Hospital and the Monument Health Orthopedic and Specialty Hospital in Rapid City will begin using the Zimmer Biomet ROSA robotic surgery system for knee replacement procedures.
A big reason for the popularity of robots, surgeons say, is that the technology has advanced dramatically in recent years. Equipment manufacturers are turning out new generations of surgical platforms that assist with knee replacement, brain surgery, spine surgery and a wide variety of abdominal and chest procedures.
Clinical data show that robot-assisted surgery can result in less pain, faster recovery, shorter hospital stays, fewer readmissions, lower costs and better overall outcomes.
The robots don’t actually perform the surgery. However, in the hands of a skilled surgeon, a robotic system can bring a new level of precision, control and flexibility to a variety of procedures, said Patrick Kenney, D.O., Regional Health’s Robotic Surgery Program Director. He has been performing surgery with the da Vinci robot since 2012, first at his practice in Atlanta and now at Monument Health.
To illustrate the growth of robotic-assisted surgery at Monument Health Rapid City Hospital, Kenney noted that surgeons used the da Vinci system in 623 cases during 2019. That compares with just 270 cases in 2018 and 137 cases in 2017.
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In knee replacement surgery, ROSA guides the precise removal of bone and assesses the state of soft tissues, both of which help the knee implant fit better into the joint. Data provided by ROSA Knee helps the surgeon make complex decisions and use technology to control surgical instruments, allowing for greater precision and flexibility during procedures.
“We can consistently have a near-perfect positioning of the components,” said Spearfish Orthopedic Surgeon Richard Little, M.D. “That can improve the function of the knee, the natural feel of the knee and the longevity of the knee. I’ve been waiting my entire career for something like this.”
“The ROSA robotic technology for total knee arthroplasty allows the surgeon to place the total knee components with extreme precision. The data acquired during implantation with the robot allows for a more personalized approach to each individual patient's needs,” said Rapid City Orthopedic Surgeon Paul Miller, M.D. “This improved positioning of the implants should lead to better long-term outcomes.”
“Better visualization, better depth perception, increased dexterity,” Kenney said, describing the advantages of the new Xi system.
The surgeon makes four small incisions through which robotic arms are inserted. Three arms are equipped with miniaturized surgical tools; the fourth has a stereoscopic high-definition camera. A key benefit of the da Vinci system, he said, is that patients experience less tissue trauma with robotic surgery.
“In fact, for the past 14 months all my groin hernia procedure patients have gone home with no narcotic pain medications at all,” Kenney said. “There’s no way I could do that with laparoscopic or even open surgery, because they would be hurting.”