Computer Assisted Surgery

Imagine you are flying to Jaipur from Mumbai. Your pilot makes an error of 2 degrees while charting your course; well you will actually land in Delhi! And you are not going to be exactly happy about it and will start wondering about the efficiency of the airline/pilot/aircraft immediately. Forget the aircraft and take the example of our car. Whenever we stop by our favorite petrol pump to check the air pressure in our tyre the machine gives a beep when the ideal pressure is reached. We never put less or more air in the tyres because we know that it will affect our mileage as well as the life of the tyre itself.

Now comes to the real issue. If you are undergoing a knee replacement surgery then you want your artificial knee exactly aligned as your original knee was, isn?t it? Till recently the surgeon used instruments and his skills to get your knee right but then there used to be errors of a few degrees occasionally. A human eye can not differentiate between 0 to 3 degrees i.e. it looks almost similar. This is where the computers have changed the surgery. We now have a computer assisted or navigation system. We are all aware that all modern aircraft have a navigation system which allows the pilot to land the aircraft safely in difficult situations such as reduced visibility. We now have a computer which guides us during the surgery to achieve 100 normal alignment!

It is important to realize that the more well aligned the knee is the longer it will last.

So how does the surgery differ from the traditional surgery? Computer assisted surgery is exactly similar to a traditional surgery. The computer has a camera unit and a screen (see picture below)

Camera unit

During the surgery I place a special array or tracker to the patient?s bone (see the picture of a bone model showing arrays or trackers)
The camera unit throws infra red rays which get reflected by these arrays and are picked up by the camera.
During the surgery the computer asks the surgeons to identify the standard anatomical landmarks and stores them for future use. The computer then can guide the surgeon to the last mm or degree in restoring the alignment because it keeps tracking the surgical steps. You can se the screen below which has actually morphed the patient?s bone.! The computer also tells me what size of implant is correct!

This adds around 15 minutes of extra time to the surgery but gives a knee which is perfectly aligned. This also adds additional cost to the surgical bill by a few thousand rupees.
We now have similar software for doing hip surgeries as well as spine surgeries! There are new developments in the software which like any other software get updated by the company.
This is not all, there more advantages of computer assisted surgery or navigation surgery. The incision or the cut we take gets reduced in size and therefore the pain is minimum. The recovery is faster and therefore the discharge is quicker. No human error is allowed by the computer. At the end of the surgery the entire data can be stored on a CD and given to the patient for record keeping! A formal report also can be printed out known as therapy report. I have printed a therapy report of a bone model which is self explanatory and speaks volumes about the accuracy.

All in all it is a win-win situation for the patient.

Dr. Shreedhar Archik was certified by the European Surgical Institute in Hamburg, Germany for the use of the navigation system.