In the impression of many people, the most common and most criticized problem in hip replacement surgery is that the length of the two legs after surgery is different. The purpose of the operation was originally to treat the injury, but the patient grew a few centimeters after the operation of the sick leg, which seriously affected the quality of life. However, the doctor's artificial operation limit cannot guarantee the accuracy of the operation, how to minimize the error value in hip surgery? A few days ago, at the third International Orthopedic Symposium at Beijing United Family Hospital, doctors operated a surgical robot called Mako to give an "accurate" answer.
Hip replacement live broadcast
The surgery broadcast live at this orthopedic symposium was a total hip replacement surgery in which the patient suffered from osteoarthritis of the hip joint, pain in the left hip and right knee at night, and difficulty walking. The operation was led by Professor Lu Jike, director of the Department of Orthopedics of Beijing United Family Hospital, and Professor Sean D Toomey, a well-known orthopedic surgeon who had completed more than 500 cases of orthopedic robot knee/hip replacement surgery, as the clinical technical guidance, and jointly conducted the Mako surgical operation demonstration (Mako robot hip replacement surgery), and simultaneously broadcast live to the public and the industry through the live broadcast platform.
The hip joint is a major weight-bearing joint in the human body, and the hips are responsible for functional activities such as walking, running, sitting up, and climbing stairs, which are limited by hip pain. According to the director of Lu Ji, in China, hip pain has become the "number one orthopedic disease" that plagues the elderly, and the incidence of women is higher than that of men, and the incidence of age greater than 60 years is higher; in addition, congenital hip diseases, such as acetabulular dysplasia, femoral head dislocation or femoral head ischemic necrosis, etc. Such diseases that arise during childhood or adolescence, after adulthood, especially middle-aged or old age, it is easy to develop secondary hip osteoarthritis.
At the scene of this event, former gymnastics champion Mo Huilan personally attended the scene and shared her sports injury experience as a gymnast. Mo Huilan said that because the training of gymnastics requires pressing the legs from a young age, many movements need to land on one leg, so the hip joint has always been the "hardest hit area" for gymnasts to be injured, "I now have a hip joint that is often stuck, and sometimes at the moment of playing, there will even be a feeling of disengagement." ”
During the operation, the doctor-operated Mako surgical robot officially entered the operating room of Beijing United Family Hospital in January this year, which is also the first orthopedic surgical robot in northern China.
In the traditional hip replacement surgery, doctors "can not see accurately", "unstable" and other problems are very common, the operation of surgery is often based on the experience and estimation of the surgeon to decide, especially in the hip replacement, knee replacement and other complex surgery, personalized preoperative design, accurate surgical operations, the doctor's technical test will be more stringent. Therefore, after traditional hip replacement surgery, patients have three types of problems that are most likely to occur, such as nerve injury, prosthesis dislocation, and "long and short legs".
According to Pan Zhongying, president of Beijing United Family Hospital, in traditional artificial joint replacement surgery, only 85% accuracy can be achieved. If you use a robotic device like Mako to do artificial joint replacement surgery, the accuracy is close to 100%. Pan Zhongying believes that since UFH's medical philosophy is to provide higher quality medical services for more people, there will be patients who pursue more advanced medical technology services for the sake of "zero difference" in accuracy.
Mako surgical robots are stationed in the operating room of Beijing United Family Hospital
The biggest feature of Mako is precision. According to Lu Jike, the Mako orthopedic surgical robot interactive real-time feedback robotic arm breaks through the limitations of traditional joint replacement surgery, and limits the osteotomy safely, accurately and within the scope of planned osteotomy, with a precision of 3-10 times more than the traditional surgical method. The robot can individually model, measure and design the patient before surgery to ensure accurate and safe operation during the operation, so as to assist in the completion of personalized and precise artificial joint replacement, which greatly reduces the incidence of different leg lengths, joint dislocations, and prosthesis loosening caused by patients due to precision problems. Using the Mako system, the patient's postoperative dislocation rate can be reduced to less than 1%, and the length error value between the patient's legs can be reduced to 1-2 mm. The increased precision of prosthesis positioning reduces impacts and further reduces the likelihood of complications such as wear and dislocation.
Professor Toomey introduced that at present, more than 20 countries around the world have used Mako surgical robots for joint replacement, and about 300 Mako robots in the United States have been put into use in major hospitals, and he himself has to complete about 20 cases of robot-assisted joint replacement surgery within a week. "Robot-assisted surgery reassures orthopedic surgeons that the prosthesis can be placed in a very precise anatomical position and play an important role in the length of the patient's postoperative leg." Professor Toomey said that because of the accurate "one-time" placement, avoiding the repeated operation of the prosthesis from small to large in the traditional surgical style, the bleeding of the surgical patients in this live broadcast was only 200 ml, and the damage to the surrounding soft tissues and blood vessels was also minimized. ”
Lu Jike said that as a non-public medical institution, only a leader like Pan Zhongying who dares to be the first to invest in the field of orthopedics can the development of high-end disciplines in the hospital have a longer space and future.
"China is in the outbreak of artificial joint replacement demand, considering the huge population base, as well as the proportion of artificial joint replacement in Europe and the United States, we hope that through our efforts, combined with the strong advantages of Mako orthopedic robots, to meet people's higher medical needs." Pan Zhongying said.
Meeting the huge demand for precision requires not only the blessing of high-end equipment, but also the learning and application of technology by the doctor group, but in traditional orthopedic surgery, the doctor learning curve is very high. Mako robot is more like a new car with automatic parking function, which can help doctors complete the crucial positioning steps in surgery efficiently, accurately and safely, implant prosthesis more accurately under the support of navigation, and the intelligent orthopedic surgical system not only makes the operation safer, more accurate and controllable, but also greatly reduces the doctor's learning curve, making the surgical procedure easy to learn to copy.
Director Lu Ji and Professor Toomey share the art center
Professor Toomey said that now through live broadcast for more Chinese doctors to conduct on-site guidance, more experience can be passed on to Chinese doctors, you can also learn the advantages of Chinese doctors, "new technology can make the two sides better cooperation, if in the future Beijing United Family Hospital Orthopedics intends to use Mako robot for full knee replacement live broadcast, I am still willing to show." ”
At present, in addition to the Mako surgical robot, the Department of Orthopedics of Beijing United Family Hospital has also introduced advanced equipment such as Spine Jackson-table operating table, X-ray machine, CT, MRI, C-arm X-ray machine, bone density meter (DAX), arthroscopic endoscopic system, intervertebral disc intervertebral foraminoscopic endoscopic system, VAC negative pressure suction device, SHOCK-WAVE soft tissue therapy instrument and other advanced equipment, fully entering the era of minimally invasive and accurate robotic surgery. Pan Zhongying said that as a social medical institution, Beijing United Family Hospital began to reverse the output of technology, setting a standard for the promotion of "high-tech" technology in social medical institutions. Such "soft power" will continue to grow and develop, and attract more partners to move forward together on the road of embracing new technologies and new concepts and improving the quality of medical care.