Originally published in The Witness, 28 April 2022. Article by Ingrid Oellermann
Pictured above: Orthopaedic surgeons, Dr James McAllister (left) and Dr Rian Smit with robot “Melissa”. The robot was used for the first time on Wednesday for knee replacement surgery at Hilton Life Hospital.
A robot nicknamed “Melissa” was introduced into theatre at the Life Hilton hospital by orthopaedic surgeons, doctors James McAllister and Rian Smit this week.
The use of the robotic arm — in this case the Stryker Mako Robot — to perform a knee-joint replacement operation was a first for the Life Hospital Group, as well as a “first” for Pietermaritzburg and surrounding areas.
The excitement over the new breakthrough surgery was palpable throughout the orthopaedic team, theatre and Stryker staff members ahead of the first operation.
McAllister and Smit underwent the week long certification process in the use of the equipment in Luxembourg last week.
McAllister explained that although robotic surgery has been around since 2006 when it was registered for use by the FDA (Food and Drug Administration), its use is not yet commonplace in South Africa.
“This robot will be the fifth in use in South Africa currently. There is one in Durban,” he said.
He added that throughout the world there are about 1 000 in use.
Smit and McAllister stressed that the robot is not a replacement for the surgeon, but helps surgeons to achieve accuracy when performing knee or hip replacement operations.
“It is important to know that the surgeon plans and performs every step of the procedure.
“The surgeon holds the saw and performs the cuts while the robotic arm makes micro adjustments to the saw position that ensures that the preoperative plan is perfectly implemented,” McAllister said.
The robotically assisted surgery allows the surgeon to place the implant far more accurately than knee or hip replacements done the traditional manual way.Doctor James McAllister
In the event of any failure by the robot, the surgeon would simply carry on manually to complete the joint replacement.
“When a patient first visits their surgeon, clinical examination and X-rays allow the surgeon to define the problem and determine whether a joint replacement is necessary. Once the patient requests robotically assisted joint replacement, a pre-operative CT scan together with extensive software planning allow for personalised, pre-operative surgical planning of implant size and position.
“The robotically assisted surgery allows the surgeon to place the implant far more accurately than knee or hip replacements done the traditional manual way,” said McAllister.
This can have positive implications for the longevity of the joint replacement, and ultimately increase patient satisfaction.
McAllister and Smit have each performed hundreds of knee, hip and shoulder replacements during their 14 and 12 years of experience respectively.
To date, the robot is not yet registered for use in shoulder replacement surgery. But due to continued advancements in the technology, it is hoped that this will happen by around 2023.
McAllister laughingly explained that it took longer than two years to negotiate the acquisition of the Stryker Mako Robot at Hilton Life Hospital, during which time he was assisted by a co-worker and friend of theirs named “Melissa”.
“When she left for the UK, we told her if we ever got it, we would call the robot Melissa, after her,” he said.
Life Hilton hospital manager, Nick Thorne, said it was an “extremely exciting day” for them at the hospital.
“This is a first in the Life Hospital Group, of which there are 63 hospitals in the country, so it is a big day for us,” he said.
The Stryker Mako Robot is considered among the most versatile of these systems available in the country at present, he added. It can be used to perform five different procedures, being total knee and hip replacements, as well as the three different types of partial knee replacements.
After performing two joint replacements using “Melissa”, McAllister said he was delighted with the robot. “It went better than I expected, given it was the first time being done,” he said.