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October 1, 2013 > The cutting edge

The cutting edge

Fremont orthopedic specialist Dr. Arthur Ting has a bit of assistance in the operating room when helping patients to regain their ability to walk without pain. Along with human personnel in the Operating Room, there is another powerful presenceÉ a robotic assistant. The Mako Rio device guides the doctor through critically precise measurements to align bones, restoring and facilitating mobility. ÒIt assists me to be more accurate,Ó says Ting. ÒA three dimensional re-creation of the knee and direct visualization of the surgical field is combined with precise ÔstereotaxicÕ mappingÓ from a computed tomography (CT) scan that guides the surgeon.Ó
Treatment and replacement of human joints, especially the knee, is a difficult process; not only is joint action in jeopardy, but alignment with the rest of the body is crucial. As medical robotics has evolved, the art of medicine remains a human endeavor, but when precise measurements and data are required to assure success, robotic assistance can be the difference between unmitigated success and continued pain and suffering. Computer assistance can advise the surgeon of variances of less than 1 millimeter, assuring accuracy. Robotic assistance allows surgeons to replace just the damaged portion of a knee rather than the entire joint resulting in a safer, less traumatic procedure with faster recovery, less pain and extended relief for the patient. Ting notes that, using this robotic device, he is able to perform an accurate ÒunicompartmentalÓ knee operation on an outpatient basis, preserving much of the natural joint.
Dr. Ting notes that the reason many medical facilities shy away from partial knee replacements is the accuracy dilemma and cost of a robotic assist device. His operating room is one of very few in the country with a Mako Reo device in house and Dr. Ting is one of a handful of surgeons with extensive training and experience to use it. Since the availability of robotic assistance for knee surgery is limited and there is a learning curve to master the symbiotic relationship of surgeon and device, most surgeons opt for total knee replacement. As a result, patients are often advised to wait until later years to undergo knee replacement surgery.
Using the accuracy and assistance of the Rio, Dr. Ting is able to operate where few others are currently able to follow. ÒThere is a learning curve with the Mako device. I did the first 35 operations with a Mako expert at my side; I knew it would take a while before I learned the nuances of the robot and how to apply it. Every knee is different. This device allows the surgeon to participate directly and accurately.Ó Time spent in the Operating Room can be brief for a partial knee replacement, under 60 minutes; patients go home the same day. Walking on the repaired knee is usually accomplished in less than a week and total recovery in 2-3 months.
Recently Stryker Corporation, a well-known medical device provider, acquired Mako Surgical for $1.41 billion to enter the robotic assisted surgery technology field. Stryker CEO Kevin Lobo was reported to say, ÒMakoÕs robotic technology has long-term potential for human joint reconstruction.Ó Mako has also introduced robotic assistance for hip replacement surgery.
For those who want to know more about this unique and innovative surgical approach to knee surgery, Dr. Ting will be speaking about Mako technology and demonstrating its abilities at DeVry University Saturday, October 5. The public is invited although reservations are requested.

Advances in
Biomedical Technology: Mako
11 a.m. Ð 1 p.m.
Presentation by Arthur Ting, M.D.
DeVry University
6600 Dumbarton Cir., Fremont
(510) 367- 0010

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