Robotic-Assisted Surgery: FAQs

When having surgery, precision and accuracy are paramount to overall success and outcomes. Robotic total hip, total knee and partial knee replacement surgery, “assists” the surgeon in attaining these goals. In the operating room, Dr. Galat will use tracking arrays attached to small pins drilled into your bone which allows real-time communication with a high-speed camera near the table. Then, real points on the joint surface will be registered with a small wand, correlating these points with a computer-generated image obtained from a CT scan of your joint prior to surgery. Once the match between your actual joint and the precise image is obtained, the perfect size and position of implants can be planned in order to maximize balance on the soft tissues. Finally, the robotic arm assists Dr. Galat in preparing the bone onto which the new components are implanted.

Currently, robotic assisted technology is used in orthopedic surgery for hip and knee degenerative joint disease, or arthritis. This includes total hip, total knee, and partial knee arthroplasty or replacement surgery. Shoulder replacement surgery is on the near horizon.

If you need total hip, total knee, and partial knee replacement surgery, Dr. Galat will let you know if you are a candidate for robotic assisted surgery. You will then have a CT scan of the joint to be replaced, which is used to create a computer-generated image of your joint. During surgery, this image will be correlated with real anatomic points on your joint, which allows Dr. Galat to plan the size and position of your implants, and then execute the plan using the robotic arm. After surgery, you will have the main incision through which the joint was replaced, and also three or four small incision through which small pins are drilled into the bone to place the tracking arrays, which allow real-time feedback to help direct the robotic arm.

The robotic arm’s primary job during surgery is to hold the tools (a saw or burr) used to prepare the bone to receive the implants. During this part of the procedure, Dr. Galat guides the saw and the saw guides Dr. Galat to precisely prepare the bone exactly as planned, using the MAKOplasty computer software, which has been correlated to your anatomy. Dr. Galat still does the incision, exposure, implantation of components, and closure of the wound.

In most cases of total hip replacement surgery, Dr. Galat uses the anterior approach. With the anterior approach, the tendons attached to the femur are not cut, unlike the lateral or the posterior approach. Rather, the natural planes between the muscles are used to approach the hip joint, which can mean less pain, and a shorter recovery time. Additionally, studies have shown a lower rate of dislocation with the anterior approach. And when coupled with robotic assisted surgery, which allows for greater precision when replacing the socket, the risk of dislocation can be lessened even further.

Dr. Galat’s time for both total hip and knee replacement surgery is about the same, whether done manually or with the robot.

Yes, through courses and/or with fellowship training. Dr. Galat has done a fellowship at the Mayo Clinic in Arizona, which focused heavily on robotic assisted surgery, and has also done live training courses, so he is an extensively trained expert in robotic assisted joint replacement surgery.