GREAT FALLS — Benefis Health System in Great Falls is the first hospital in the state to utilize a new surgical tool called ROSA: Robotic Orthopedic Surgical Arm.
The robot helps surgeons during routine knee replacement operations, by making use of its optical trackers and cameras to map out a patient’s knee down to a half-millimeter.
“We're able to actually understand how the knee behaves with physical manipulation right then and there, and we're able to respond to it right then and there and give the patient as close to a customized, positioned knee replacement as we can,” says Jace Bullard, an orthopedic surgeon familiar with the technology.
Michelle Lake, an RN at Benefis, says there’s been concern from patients surrounding the robot’s programming.
“Our surgeon is still making the incisions. They're still doing the surgery. It's just a guide so that they can see kind of in real time what needs to be adjusted,” she says, much to the relief of patients. “Most people are excited about the technology to help guide the surgery, but they still want the surgeon to perform the surgery, and this facilitates that.”
Randy Gray was the first patient to undergo a ROSA surgery at Benefis, and says he feels great in the five weeks since his full knee replacement. He is also a former attorney and mayor of Great Falls.
“The machine is just so precise,” Gray says, “Before they made the incision, they knew the length of every tendon and the details of my bones and musculature. This is my story of joy. I’m astounded how well this has worked out, right here in our town.”
Here is a Q & A of ROSA’s procedure provided to MTN News.
What does ROSA do?
- During surgery, the robot uses a camera and optical trackers for incredibly detailed tracking of the patient’s knee, similar to the way a car’s GPS works, but down to a fraction of an inch. This helps ensure the surgery plan is executed precisely as the surgeon intends. Throughout the surgery, the robot sends the surgeon data about the knee, which helps inform them how to position the implant based on each person’s unique anatomy. ROSA acts primarily as a tool and guide for the surgeon. It does not actually perform any part of the procedure on the patient.
Why does that matter to a patient?
- With patients living longer and getting total joint replacements younger, it’s even more important to have as perfect an alignment as possible for the greatest prosthesis longevity. Problems with alignment and inaccurate bone cuts can lead to failure of a knee replacement and the need for revision surgery. ROSA helps improve accuracy and allows surgeons to tailor the knee replacement in a way that may feel more natural and satisfying to patients. The expectation is that over time, using ROSA will mean fewer revisions, improved pain levels, superior functional results, and, ultimately, happier patients.
What other benefits are there to robot-assisted surgery?
- Unlike some robotic platforms, ROSA does not require a pre-operative CT scan or MRI, which reduces expenses and exposure to radiation. The procedure may also be slightly less invasive, which could reduce pain and speed healing. Historically, previously implanted hardware sometimes presented a problem for patients undergoing knee replacement. In certain situations, using ROSA allows surgeons to leave previous hardware in place, eliminating the need for additional or more complex procedures. In addition, the use of ROSA reduces the number of tools needed compared to conventional techniques, which in turn reduces time and cost for the teams that clean and prepare the instruments.