Transcription:

Adam Ragusea (Host): Robots. Robots are everywhere. They are in factories and they are in hospitals. Doctors are using robots to assist them is sophisticated surgeries and that can have benefits for you as a patient. What kind of surgeries? What do the robots do? Let’s ask Dr. Chesley Durgin, an orthopedic surgeon at Capital Regional Medical Center. This is Helmet of Health, a podcast from Capital Regional Medical Center and Dr. Durgin, what do you use robots for in your operating room?

Chesley Durgin, MD (Guest): I primarily use the robotic procedure for total and partial knee replacements. And also occasionally some hip surgery as well if there is severe hip deformity or dysplasia. But mostly for osteoarthritis surgery of the knee.

Host: Well pain a picture for me. We are not talking about an anthropomorphic robot going bleep, blurp, blurp, I will perform your surgery now. What specifically does a machine look like that would help you in a surgery like this and what would it do that you wouldn’t be doing with your own hands?

Dr. Durgin: Sure, so it’s really a guide that helps make the surgery more precise and accurate. It’s a robotic arm that either has a saw for a knee replacement or it’s a burr that’s used for a partial knee replacement. And what it’s doing is accurately constraining the cuts to within a degree or so of rotation and within a millimeter or so of accuracy which is much more precise or accurate than can be reliably done without use of the robot. But it’s not doing any of the cutting or like per se, it’s more of just trying to guide the saw and keep it in a very precise plane to execute the surgical plan. It really – it changes the surgery instead of making the bone cuts and then placing the implants and then balancing the knee to preoperatively planning where the implant placement will be to predict that the knee will be well-balanced and then executing that plan at surgery. And it’s a little bit of a different philosophy.

Host: What’s the experience like for the patient?

Dr. Durgin: So, the patient will be asleep just like they would for most knee replacement surgeries. For the most part, the knee replacement surgery is done under a spinal anesthetic which makes the job of the anesthesiologist a little bit easier to control blood pressure and everything like that which leads to less bleeding and less anesthetic is used for the patient. It also allows the patient to still have some good residual pain control when they wake up from surgery so that their pain is pretty reliably well-controlled. They also will get a nerve block as well as a bunch of local pain medicine placed in the operating room in the knee, all with the goal of really making sure that they wake up with a controlled pain and that can lead to a much better patient experience and controlled pain throughout all of their rehab if you are able to start off that way.

Host: So, when it comes to the use of robotics; is this something that everybody is doing when they do knee replacements now or are you and your colleagues ahead of the game on this?

Dr. Durgin: It’s definitely on the cutting edge of things, but it’s very widespread. There have been several million joint replacements done using robotic surgery at this point over the last decade or so. the knee replacement has been around for about five years and the partial knee replacement for probably a little bit better than a decade in. It’s been increasingly widespread and utilized.

Host: So, if a person who is listening needs a joint replacement surgery; what should they ask their doctor?

Dr. Durgin: The major things in deciding whether you are going to proceed with a joint replacement has a lot to do with what the patient’s functional level is and how well-controlled their pain can be with some of the other options which might include anti-inflammatory medications, perhaps a steroid shot, physical therapy, working again strengthening the joints, sometimes bracing can be helpful. But it’s really a discussion of when that’s really not working, and their pain is advanced to the point that they are not functioning well and not able to do the activities that they need to or even walk around their home or even some of the basic activities of daily living. At that point, then I think it’s where the discussion becomes about what can be done to increase their functional level and that’s when the discussion, I think for a joint replacement really becomes more appropriate.

Host: All right, thanks Doc. Dr. Chesley Durgin is an orthopedic surgeon at Capital Regional Medical Center. And thank you for listening to Helmet of Health. Head to www.capitalregionalmedicalcenter.com to get connected with Dr. Durgin or another provider. If you found this podcast helpful, please share it on your social channels and be sure to check out all of the other podcasts in the library.