On May 26, Dr. Bargar made history again as he performed joint replacement surgery on Warren Roberts' right hip at Sutter General Hospital with the new-generation ROBODOC Surgical System, recently approved by the FDA for total hip arthroplasty procedures. The new ROBODOC Surgical System, which provides a higher level of precision and accuracy than is possible with the conventional technique, is the only "active" robotic system cleared by the FDA for orthopaedic surgery.
The ROBODOC Surgical System has been used in more than 24.000 procedures worldwide, but Warren Roberts' surgery marks the first commercial use of the device in the United States since FDA clearance. Sutter General will become a demonstration site for ROBODOC as it begins to be used by other United States surgeons.
After the original surgery 15 years ago, Warren Roberts' left hip is still working well, demonstrating the longevity of the surgical procedure and implant. "It was like being born again", stated Warren Roberts, 68, the former superintendent of the UC Davis Arboretum, of the first ROBODOC surgery. "The years of pain fell away."
This past year, Warren Roberts' right hip began affecting his mobility, forcing him to use a cane. Two days after surgery, he's getting up and going home. "Now I have matching hips", he quipped. Dr. Bargar, who also has two degrees in engineering, stated: "It has been my passion to bring the precision of the engineering world to the practice of orthopaedic surgery."
ROBODOC provides significant advantages for hip and knee joint replacement surgery that benefit the patient, physician and hospital. "ROBODOC is able to perform the surgery more precisely than the usual manual technique, and this is a tremendous asset for the patient", stated Dr. Bargar. "We are always striving for more precision because it means better mechanics and performance for our patients."
The advantage ROBODOC provides is in both the pre-planning stages of the surgery and during the preparation of the bone to receive the implant. In pre-planning, the current conventional technique uses X-rays, which provide only 2D data. Therefore, they are subject to magnification and rotational errors, which can cause less precision in the surgery. When using the ROBODOC Surgical System, the surgeon first plans the surgery on a computer workstation, called ORTHODOC, using 3D data from a CT scan of the patient.
The surgeon selects the type and size of implant best suited to the patient on the computer and then positions it in the desired orientation by manipulating an image of the implant using the mouse. This so-called "virtual surgery" allows the surgeon to try different implants and orientations to obtain the best fit for the patient. The final computer plan made by the surgeon provides information that is then loaded onto the ROBODOC device in the operating room.
During conventional hip replacement surgery, the surgeon prepares the surfaces of the bone for the implant by hand. The surgeon uses hand tools that include broaches, mallets and power reamers, which do not always provide the desired fit and position of the implant. Using ROBODOC, the robot precisely mills the bone surfaces, ensuring the exact fit and position of the implant based on the pre-operative plan.
Sutter Medical Center, Sacramento, which is ranked in the top 10 percent in the United States for orthopaedic surgery and joint replacement surgery by HealthGrades, has a dedicated and organized joint replacement programme called the Sutter Joint Replacement Center. The surgical teams have the largest joint replacement volume of any hospital in Northern California and outcomes are among the highest.