Applications and Benefits of Robots in Surgery Theatres: Dr. Doron Dinstein

In this interview, AZoRobotics talks to Dr. Doron Dinstein, VP Marketing at Mazor Robotics about the applications and benefits of using robotics in surgery theatres.

Please provide a brief overview of Mazor Robotics

Mazor Robotics has developed the world’s only robotic guidance system for spine surgery. The Company’s technology is transforming spine surgery from freehand procedures to highly-accurate, state-of-the-art robotic-guided procedures that raise the standard of patient care by providing better clinical outcomes.

What are the benefits of using robotics in surgical applications?

Numerous studies and trials have indicated that robotic surgical applications can result in more accurate and less invasive surgeries, leading to safer procedures.

For example, in a multicenter study using SpineAssist® (the first-generation of the company’s robotic surgical guidance system), Mazor Robotics technology was shown to be 98.3% accurate for implant placements in spinal surgery. By comparison, freehand implant placements are documented in literature to be misplaced in about 10% of cases. Additionally, the study demonstrated that robotic-guided spine surgery with Mazor Robotics technology contributes to significantly lower rates of misplaced spinal screws and neurological deficits than freehand procedures.

In addition to better accuracy, Mazor Robotics technology enables minimally invasive surgery (MIS) with less radiation than conventional MIS. The ability to perform “minimally invasive” for spine procedures means the surgeon doesn’t have to open the patient’s entire back to perform surgery, resulting in less scarring and blood loss, fewer complications, and faster patient recovery time.

Mazor Robotics specializes in spinal surgery. What are the main reasons for using robotic guidance in this particular type of surgery?

Spine surgery is extremely complex and there are a number of potential complications that can result from such invasive procedures. Our system benefits both the surgeon and the patient, helping to increase accuracy, reduce radiation exposure, and prevent such complications such as neurological injuries and others.

Mazor Robotics is also beginning to go beyond spinal surgeries. Our Renaissance™ Surgical Guidance Robot received the CE Mark in Europe for brain surgery.

You recently released Renaissance™. Can you tell us about this product and what is so special about it?

Renaissance™ is our next-generation surgical guidance robot, powered by clinically proven Mazor Robotics technology. It maintains the same high level of precision - with accuracy to 1 mm or 1/25 inch -and includes new features that require less radiation, even for minimally invasive or complex procedures.

Renaissance™ has a completely new design and interface, as well as state-of-the-art hardware and software technologies. In addition, Renaissance™'s advanced CT-based 3D planning software allows surgeons to create a customized plan or surgical blueprint for each patient and condition before entering the operating room.

What types of spinal surgery is it suited to and what conditions is it designed to help treat?

Renaissance™ is designed for use in posterior and lateral approaches for open, MIS, and percutaneous spine surgeries. Specific procedures include spinal fixations, and scoliosis corrections, osteotomies, transfacet and translaminar-facet implant placements, among others. Renaissance™ expands on Mazor Robotics’ core technology clinically validated in previous models which were successfully used to insert spinal implant placements and other spine surgeries. It can also be used to assist with pediatric spine surgeries, such as idiopathic adolescent scoliosis procedures, which are often challenging due to the patients’ small, complex anatomies.

How does Renaissance™ benefit patients compared to traditional techniques?

Patients suffering from back problems in need of surgery look for successful, definitive and safe procedures. Using Renaissance™ provides patients with “peace of mind”- due to the high level of accuracy and increased safety. It also enables less invasive spine surgeries that require less radiation, and can result in faster healing time post-surgery.

What about surgeons? Does your system also help them plan their surgeries before actually setting foot into theatre?

Yes, Renaissance™'s preoperative CT-based 3D planning software allows surgeons to easily plan an entire surgery customized for each patient and their condition prior to setting foot in the operating room. They use the patient’s X-ray images to map out the procedure. This includes optimizing implant sizes, and planning exactly what angle they will be inserted and placed within the spine. (A much more complex task than it sounds!) Before the actual operation, surgeons can also review this plan in video mode, step-by-step, simulating the surgical outcome, further increasing patient safety.

Are specially trained technicians required to operate Renaissance™ or are the surgeons able to operate it themselves?

While the technology is very user-friendly, surgeons undergo a training course on how to operate Renaissance™ by themselves. Actually, several studies have been published emphasizing the ease of use and short learning curve for Mazor Robotics technology.

With the aid of Renaissance™, do you see the actual surgery times decrease?

Yes, surgery time may decrease due to the ability to better prepare for the procedure ahead of time, especially for challenging anatomies as well as for MIS. (Since less tinkering with the imaging equipment is needed, this also means far less intraoperative radiation is needed). However the key attribute of the system is its high accuracy, which results in fewer complications.

Being able to more accurately place implants will obviously benefit the patients with overcoming their conditions. Will this also reduce post surgery recovery times?

Yes, patient recovery time has been shown to be shorter after using Mazor Robotics technology. It enables more minimally invasive procedures, meaning less cutting and less pain and blood loss, leading to quicker recovery.

A study of 112 cases using Mazor Robotics technology compared to freehand surgery reported reduced hospital stays, as well as fewer complications and revisions, less radiation and reduced patient pain. All of this allows patients to return to their daily activities more quickly.

These all sound like exciting developments for people suffering from spinal ailments. Is Renaissance™ available for commercial sales and are surgeons currently using it?

Yes, Renaissance™ is already being used in numerous leading medical centers throughout the US and Europe. It is both cleared by the FDA in the USA and has received the CE Mark in Europe.