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Black Hills Surgical Hospital using robotics for knee, hip replacements
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Black Hills Surgical Hospital using robotics for knee, hip replacements

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New robotic technology at Black Hills Surgical Hospital is bringing knee and hip replacement patients the hope of less pain and more satisfaction.

Eight knee and hip replacement patients on July 12 were the first to undergo surgery performed with the assistance of two Mako Smart Robotics robots. The Mako Smart Robotics are the first in the Black Hills and eastern Wyoming region that Black Hills Surgical Hospital serves. The technology is unique in that it can assist surgeons with total and partial knee replacement and total hip replacement surgeries.

By the year 2030, total knee replacements in the United States are expected to increase 189%, and total hip replacements in the United States are projected to grow 171%.

“We spoke to each patient individually and explained the technology in detail,” said Dr. Jeff Marrs, a board-certified orthopedic surgeon at the Hip and Knee Center at Black Hills Orthopedic and Spine. “Everyone I spoke to said they’re excited.”

Marrs and Dr. Luke Mortimer, orthopedic surgeon and president of Black Hills Orthopedics, performed Monday’s surgeries with the Mako Smart Robotics.  

“The nice thing is Dr. Marrs and myself do a lot of joint replacements, and this is … another safety measure to ensure that we can have a personalized plan for each patient and we know more, cut less, protect soft tissues,” Mortimer said. “It’s exciting, it’s unique and it’s really good for the community.”

“We are proud to be the first hospital in our region to offer this highly advanced SmartRobotics technology to our patients,” said Dr. Lew Papendick, chairman of the Management Committee at Black Hills Surgical Hospital.

The robots arrived at Black Hills Surgical Hospital on June 24. They were chosen after about three years of training and research, Mortimer said. When fully trained and credentialed on the robotics technology, eight surgeons at Black Hills Surgical Hospital will use it.

“Dr. Marrs and myself have been very thoughtful about this process,” Mortimer said. “After a lot of research and training, this does make a difference in terms of patient care and outcomes. The robotics-assisted surgery is not taking the place of surgeons. It’s assisting and it’s another tool for a patient to have a great outcome.”

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The robotics technology has existed for some time, Marrs said, so Black Hills Surgical Hospital could study data about how it benefits patients. Data shows that patients tended to have less pain, spent less time in the hospital, and needed fewer pain-relieving narcotics. For knee replacement surgeries, clinical studies also show that use of the robotics technology reduced the need for inpatient physical therapy and improved patients’ ability to bend and flex their knees.

“We have invested a lot of time and research into what brand of technology we’d like to bring to our hospital. It’s been a desire to bring this technology for some time,” said Marrs, who began his training three years ago. “This particular Mako technology, I believe, is the gold standard. … It’s the only one that actually takes CT scans to produce a 3D image and map that to the patient’s anatomy. It’s the only one that allows us to make precise cuts where we want to make precise cuts.”

The technology allows surgeons to see a patient’s anatomy beyond what they could from X-rays and during surgery. The robotics allows a surgeon to take a CT scan of the patient’s anatomy before surgery, and that data is loaded into the robot, Marrs said.

“During surgery, the robotics takes what we’re seeing (in the patient’s body) and maps that to the CT data so it makes sure we have them exactly matched,” Marrs said. “The robotics is a degree of enhancement to give us more information and more control. It gives us a better idea of where we’re cutting and how to produce a precise cut.”

The robotics use haptic feedback — think of the sensation you feel when your phone is in vibrate mode — to guide surgeons as they operate. It can prevent surgeons from cutting soft tissues such as nerves, arteries and ligaments, Mortimer said.

“That electric device is still physically in my hand but the robotic technology gives me feedback,” Marrs said. “That allows us to cut where we want to cut and disrupt less soft tissue. There’s potential for less bleeding and disruption of pain receptors so people can have less pain.”

“We do a joint replacement for a patient and we want them to have less pain, better function and if we can get the implants positioned for better alignment and better stability, there’s a higher probability the patient will be satisfied with the joint,” Marrs said.

“Our patients have great outcomes. Black Hills Surgical Hospital is one of the top 20 outcomes in the nation for joint replacement, and our goal is to improve upon that. Our goal is to make ourselves the best,” Mortimer said.

Ultimately, Marrs and Mortimer said, robotic technology is one of the factors that will produce a good outcome from surgery.

“The most important factor is the patient and their commitment and the things they’re actively engaged in to produce a good outcome, and then the surgeon is second most important in terms of skill level. We encourage patients to find somebody they trust and believe they can get good results with,” Marrs said.

“If the public and patients have questions or concerns, that’s where having a good discussion with a surgeon is the best you can do. We can help answer questions, discuss the pros and cons and come to a decision (about medical care) together,” Mortimer said. “Our job is to let people know how we can help them. When the time comes, if it comes, for surgery, that’s what we’re here for.”

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