MILLCREEK — Thanks to new developments in robotics, patients who need spinal fusions now have access to a less-invasive, more-precise surgery with a significant drop in the time needed for recovery and pain management, a St. Mark’s Hospital surgeon said Wednesday.
On Oct. 6, St. Mark’s Hospital became the second hospital worldwide, and first community hospital, to complete spinal fusion surgeries on patients using a tool called the Globus Medical ExcelsiusGPS — a surgical robotic arm that utilizes guiding technology and was first approved by the Food and Drug Administration in August.
Dr. Kade Huntsman, the spinal surgeon at St. Mark’s who completed the facility’s first surgery and seven others in the weeks since, called the tool “pretty darn easy to learn.”
“It makes good surgeons better,” Huntsman said. “It’s incredibly accurate and pretty simple to use.”
John Hopkins Hospital, a teaching and research institution at the university of the same name , had performed the first surgery using a Globus Medical ExcelsiusGPS just a few days earlier.
Efforts have been made over the years to reduce the invasiveness of spinal surgery, which in general is “pretty barbaric,” Huntsman said.
“For the most part, it’s pretty old-fashioned,” he said.
Academic research shows robotics and sophisticated imaging have both played a part in spinal surgery for several years, but they’ve never been integrated seamlessly, Huntsman said.
“This is the first time ever we’ve been able to match guiding technology with a robotic arm,” he said.
Without the tool, according to Huntsman, he requires a somewhat larger incision into the patient’s spinal area — with enough room so that he can “feel the anatomy” with his hand. Now, he said, sophisticated imaging employed by the device allows him to confidently make an incision no larger than the 1 centimeter diameter of the base of the screw he is inserting into the patient.
“It (the robotic tool) can tell you if you’ve got the right angle, that you’re going deep enough, that you’re not too deep,” Huntsman said. “We know exactly what (the area) looks like.”
In a typical spinal fusion surgery, muscle must be peeled off spinal discs and afterward becomes scar tissue, causing significant post-surgery pain for patients, he said. The heightened precision of the new tool means that isn’t necessary, according to Huntsman, ideally reducing the severity of patients’ pain treatment regimen after surgery — and perhaps curbing the potential for an opioid addiction.
The precise placement of screws enabled by the robotic arm also reduces the chance of complications, Huntsman said, which are typically a significant risk in a spinal fusion surgery due to the prevalence of surrounding nerves.
“I have a 3-D representation of the spine, so I can make sure I have everything exactly where I want it,” he said. “It’s kind of like disasters everywhere (nearby), so (the placement) has to be perfect.”
One limitation in other imaging surgical tools has been a total reliance on the patient being completely still, wherein “if the patient moves, you’re in trouble,” the surgeon said. Now, “if anything moves, the system knows where it’s moved.”
“This is a huge leap forward,” he said.
At present, the new technology aids in cervical, lumbar and thoracic spinal fusions. Huntsman said he is hopeful that future development of the robotic arm, when paired with the technology’s precise imaging, will allow for the improvement of other sensitive surgeries as well.3 comments on this story
Huntsman, who has also been tasked with training other surgeons at St. Mark’s Hospital on using the new equipment, praised the results of the initial procedures performed in recent weeks, though he cautioned the patients he has worked on “are still in the early recovery period.”
Huntsman said his first use of the equipment on a patient, who had six screws inserted for spinal fusion, “went flawlessly.” He’s been in touch with her since and her mobility is encouraging, he said.
“She said she went trick-or-treating last night with her family, so she’s doing really well,” Huntsman said. “She’s feeling great, three weeks out.”