New robot a step up for Halifax hospital's hip and knee surgeries

For Dr. Michael Dunbar, a new robot purchased by the QEII Health Sciences Centre in Halifax could mean taking the effectiveness of knee and hip replacement surgery to the next level.

Dunbar, an orthopedic surgeon at the hospital and a surgery professor at Dalhousie University, is spearheading a project that will use the Mako SmartRobotics system — a robotic arm controlled by a surgeon during hip and knee surgeries. 

It allows a joint implant to be positioned more precisely than with the human eye, making orthopedic surgery more personalized and effective. 

Dunbar said orthopedic surgery already has a high success rate, but is usually standardized based on the average human body.

"We've come very, very far by standardizing procedures and saying, 'On average, this is how we should do it,'" Dunbar said. The robot "is revolutionary in the fact that it allows us to start to think outside the average and say, 'How would I customize the procedure to you?'"

There are more than 1,000 Mako SmartRobotics systems in use worldwide, but only two in Canada. The one at the QEII Health Sciences Centre was bought last month.

The robot will allow for unique, case-by-case surgery, taking into account the patient's specific anatomy. It changes both the pre-surgery planning process, and the surgery itself.

"We're able to plan the surgery using a computer model of the implant and place it on the bone where we think is best before we even get to the operating room," Dunbar said. "And then … once we've set that position, we can then lock it into the robot."

The surgeon is still in control of the operation and guides the saw, but if the saw moves outside the bone, the robot shuts off.

Patients will benefit 

Dunbar said this will have an impact on the healing process for patients.

"The early studies would suggest that pain and bleeding are reduced and subsequently length of stay is reduced," he said. 

The biggest benefit could be that the more precise positioning of an implant could lead to a longer functioning life and fewer redo surgeries down the road. 

But Dunbar said people shouldn't get too excited yet, as the implementation of the technology will be a gradual process. 

Nova Scotia's health authority hopes to have the robot in use for some partial and total knee replacements later this month, but only two doctors are currently certified to use it, so many surgeries will continue with traditional methods as training continues.

The introduction of the robot will be accompanied by a research study led by Dunbar, which he hopes will apply to the use of robots in many fields of medicine. 

Donor-funded

It took the team at the QEII over a year to secure the Mako robotics system. The robot and related research will cost over $2.5 million, and the QEII Foundation will be looking to donors to foot the bill. 

"It's really the kindness and generosity of our donors that will make this leading-edge care possible," said Julie McKean, vice-president of philanthropy at the QEII Foundation. 

McKean said a large fundraising effort is about to begin. 

"It will take many donors to come together to make this a reality and for us to reach our goal."