Robotic surgery

The emergence of robotic surgery

Several important interacting factors have led to the development of robotic surgery. As in every field of medicine, technological innovation is increasingly evident, and robotics is a key driver. Specifically the emergence of orthopaedic robots has been influenced by the knee replacement and hip replacement number of joint replacements is steadily increasing and with it the demand for more durable and better quality prostheses.

For younger patients, more durable and long-lasting implant solutions are required to meet long-term functional demands. Joint wear, which occurs earlier in older age groups, is mainly caused by a sedentary lifestyle or even excessive physical activity, genetic predisposition or obesity.

While joint wear and tear is a natural physiological process, it can also result from a variety of other factors. There are various underlying conditions that can lead to wear and tear, such as hip sprains, underdeveloped hips or even accidental damage. Metabolic diseases, alcoholism or taking large amounts of steroids can also cause the bone supporting the cartilage to die, which may ultimately require knee replacement surgery.

From there are many different indications for joint replacement, which is not limited solely to age.

The rise of robotics in healthcare

1. Computer navigation: Computer navigation: The development of robotic surgery began with computer-assisted navigation systems. This is not yet a robot, but rather a special device that gives advice and numerical support for measurements and helps the surgeon to implant the prosthesis more accurately by providing rudimentary visualisations.
2. First generation robots: Robotics developed further after the navigation device and the first-generation robotic systems began to appear in Hungary in the early 2000s. It now thinks, calculates and, after a much deeper analysis, advises the surgeon on how to implant the prosthesis more accurately.
3. Second generation robot: Second-generation orthopaedic robots such as CORI are currently state-of-the-art technologies. This type includes several innovations that its contemporaries do not, for example CORI is the first semi-autonomous robot, one that has some degree of autonomy but is still under the control of the surgeon. It analyses the data collected by artificial intelligence (AI) and provides the surgeon with a customised solution.

Why the CORI robot?

The CORI robot, designed by Smith & Nephew, is an orthopaedic robotic surgical system that uses artificial intelligence, mainly for knee replacement. The aim of using the CORI robot is to help surgeons increase surgical precision and make the operation safer for the patient.

The CORI robotic surgical system provides surgeons with a perfect virtual model in a semi-autonomous way - i.e. with some degree of autonomy - simulating the parameters for the exact implant insertion and the outcome of the surgery. The robot is also used for professional cartilage and bone removal. This is done with the help of a handheld robotic-assisted milling tool that follows the surgeon's instructions to the tenth of a millimetre.

Result: With robotic assistance, surgeons can make more precise incisions and sutures, which can bring better results for patients. The aim is that after the recovery period the patient should be completely free of complaints and there is nothing to restrict your movement in everyday life.

Why is the robot unique?

The CORI robot is a hand-held digital instrument that offers the benefits of robotic technology without the need for a large, arm-based robotic system. This reduces the space requirements and costs of the equipment.

The technology allows CORI's system to adapt to different surgical techniques and implants, so surgeons can tailor the surgery to the needs of each patient. The system's intelligent software analyses data collected during surgery and provides real-time feedback to the surgeon.

Advantages of the robot:

• Supports minimally invasive exploration, thereby helps to minimise tissue damage, helps speed up the recovery of patients.
• The robot allows you to more accurate implant placement, thus reducing the risk of complications and the need for revision surgery .
• With the CORI robot, there is no need for preoperative MRI or CT imaging tests (enough for the X-rays). In the planning phase, the robot generates a highly accurate 3D model of the scanned cartilage and bone surfaces in real time. One visualisation on the CORI tablet is exactly like a CT scan, which is displayed in real time.
• The knee replacement surgeries about twenty percent of patients may experience minor or major problems during the course of the - even a difference of 2-3 millimetres can cause permanent complaints. Robotics significantly increases accuracy, and reduces the deviation to 0.5 millimetres, which improves this rate.
• Robotic surgery is less stressful for patients and statistics show that patients leave hospital sooner after surgery.

• It is also a safe solution in case of metal allergy: the CORI robot allows the implantation of hypoallergenic, Oxinium prostheses.
• Another advantage of the technology is that patients with special anatomies can be treated more effectively. So now robotics and artificial intelligence are the cornerstones of technological innovation.
• The technological sophistication of the CORI robot is illustrated by the fact that can also be used for revision prosthesis surgery. In these cases, the benefits mentioned above also apply.

When you look at the sum of the positives of robotic surgery, it is not surprising that robotics and artificial intelligence are now a mainstay of technological innovation.