Robot arms just what sleepless doctors ordered

Local | Jane Cheung 29 May 2020

A robotic arm capable of assisting in joint replacement procedures has increased surgical accuracy by up to 98 percent and minimized errors from doctors "who do not get enough sleep," a University of Hong Kong medical team said.

The university's faculty of medicine debuted the technology at Queen Mary Hospital last year - making it the first public hospital to utilize the robotic arm for knee and hip joint replacement surgeries.

To date, more than 160 robotic procedures have been performed successfully, with all patients making good rehabilitation progress.

Peter Chiu Kwong-yuen from the department of orthopedics and traumatology said bone specialists only needed to go through the procedures 10 times under supervision before they can do it by themselves.

He expected the technology to be in widespread use for joint replacement procedures in future.

His colleague, Yan Chun-hoi , said most patients can walk on the same day of surgery and 84 percent can go home right after being discharged without having to go to a rehabilitation center.

The conventional procedure sees doctors use manual instruments to remove weakened bone structure with cutting jogs and then place artificial joints with their hands.

"Implant alignment and soft-tissue balance cannot be accurately quantified and relies heavily on the surgeon's experience," he said.

"Although navigation has emerged in the past 20 years, it can only offer intraoperative guidance to surgeons, while bone removal is still uncontrolled with the risk of error."

The new technology enables doctors to precisely remove undesirable parts of the joints before inserting the artificial joints.

"The robotic arm only moves within the designated area of surgery, and it reduces the chance of doctors accidentally cutting the nerves or tissues of the patient. Thus it reduces blood loss and facilitates recovery," Yan said, adding that the accuracy of artificial joint placement had risen up to 98 percent compared to 80 percent in manual surgeries.

Yan said Queen Mary conducts around 500 joint replacement surgeries each year and the hospital wishes to do 200 of them with the new robotic technology. Patients will have to pay HK$2,000 extra for a preoperative computer scan for the robotic arm option.

"We'll suggest younger patients do the surgery by robotic arms for a higher efficiency because they can enjoy more activity with the new joints for a longer period of time," he said, adding that the enhanced accuracy with the technology can also help patients with complicated conditions.

He noted that in Hong Kong only the HKU medical team and a private hospital have procured the robotic arms, which cost HK$15 million per set, while the US manufacturer has lent two sets to other public hospitals.

Dwarfism patient Jacqueline Tam Chor-wing, 34, has under-developed bone structures that are much smaller than healthy people.

Yan said her bones were much more fragile and dislocated, causing them to rub against one another and eventually developed into osteoarthritis after cartilage protecting her joints worn down over time.

She suffered from extreme pain in her legs four years ago that she had to move around in a wheelchair.

Tam underwent the new procedure in August, recovering quickly and being able to walk the day after surgery.

"Doctors gave me hopes in life. I didn't think I could ever walk again," she said.

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