KZN hospital celebrates 100th robotic-assisted othopaedic surgery

Orthopaedic surgeon Satish Bugwandin with the Mako Robot. l SUPPLIED

Orthopaedic surgeon Satish Bugwandin with the Mako Robot. l SUPPLIED

Published Nov 4, 2022


Durban – Patients requiring knee replacement surgery will now spend less time in hospital and heal faster thanks to a major advancement in surgery.

This week, the Lenmed Ethekwini Hospital and Heart Centre celebrated another major milestone, with orthopaedic surgeons performing the 100th robotic-assisted knee replacement surgery using the Mako robotic-arm.

Dr Satish Bugwandin, orthopaedic surgeon at Lenmed Ethekwini Hospital and Heart Centre, explained that the robotic arm-assisted total joint replacement procedure was performed on a patient requiring a knee replacement.

“We started the procedures late last year and progressed to 100 as a unit between orthopaedic surgeons Dr Calvin Veerasamy, Dr Neetesh Patel and Dr Luren Reddy.

“The robotic surgical system helps to set up and define a clear surgical field when we have to cut and size the bone. Pre-operatively, the patient will have a scan which allows us to plan the surgery accurately.

“Intra-operatively, the robot assists us in making bone incisions more accurately and allows us to remove less of the damaged bone,” explains Bugwandin.

He says by leaving more bone or tissue behind, surgery is “personalised” to the patient’s anatomy. The Mako robotic arm doesn’t perform the replacement surgery, nor does it make decisions to move. It is guided, at all times, by the surgeon and can ensure that partial or total replacement surgery is more accurate than ever before.

Traditionally, surgeons would set cutting blocks for surgery and with the robotic apparatus, doctors are able to work with safer boundaries so the risk of injury to surrounding tissue or bone is lower.

“With more accurate cutting, there is also a better fit of the implant and the implant will last longer. Due to the precision of the procedure, the patient’s stay in hospital is reduced from four nights to two nights while healing can take place at a faster rate,” says Bugwandin.

Bugwandin was assisted by fellow orthopaedic surgeon, Dr Calvin Veerasmy, who noted that an important factor in this type of surgery was the pain relief factor.

Orthopaedic surgeons Dr Satish Bugwandin and Dr Calvin Veerasamy discuss the groundbreaking Mako SmartRobotics knee and hip replacements. l SUPPLIED

He says because there is very little dissection of soft tissue with the robotic apparatus, the computer does the balancing and it is less invasive. Joint replacement surgery is often required in older patients or athletes where the cartilage in the joint has worn out.

“There are also cases where if a person has suffered injury to a joint, they may require replacement surgery. In general, it’s a disease of the elderly and there are very limited circumstances where we consider operating such a procedure on a young patient,” adds Bugwandin.

Veersamy says another positive factor in this type of procedure is that even though the size of the incision is the same as in previous surgeries, the cuts are more accurate and precise and mean less soft tissue is dissected

“By being more accurate, we are assured that the implants will last much longer,” he adds.

Although this type of surgery is not new to South Africa, the doctors say there are more advancements taking place at a rapid pace and soon this procedure will be introduced to include shoulder and spine surgical procedures, as well as sport injuries.

While the procedure is available for patients in private medical facilities at the moment, Bugwandin says it is exciting that a public hospital in Cape Town is in the process of acquiring a machine of its own and will soon be rolling out the elective surgery to other state-owned hospitals.

He adds that with this introduction and the forthcoming National Health Insurance, there will be an exciting opportunity for experienced medical professionals to train other doctors.

“Once they have it, we hope this will spread to other state-owned hospitals and will be accessible to the broader public. Through public-private partnerships, there will be opportunities for us to use our skills and expertise to assist,” says Bugwandin.

“The Lenmed Ethekwini Hospital and Heart Centre has helped us get this type of technology. Moving forward, we are excited to be at the forefront of medical innovation,” adds Veerasamy.

Each medical aid and plan is different depending on the level of a patient’s cover and there are no additional charges incurred to the patient as it costs the same as traditional joint replacement surgery.

At the forefront of medical technology and innovation, the latest achievement comes just weeks after KwaZulu-Natal cardiologist and electrophysiologist Dr Brian Vezi inserted the world’s tiniest, leadless pacemaker into a man’s heart at the specialist facility.

Commenting on the milestone, hospital CEO Niresh Bechan, says this has meant huge benefits for communities.

“The procedure expedites their healing time so they are able to return to work faster and essentially get back to their busy lives quicker,” he said.

Lenmed CEO Amil Devchand adds: “It is through work like this, leveraging off the best and most innovative the industry has to offer, that we fulfil our purpose of building healthier and prosperous communities and ensure we make a positive difference to the lives of those within our care, as well as their families.

“We are incredibly proud of reaching the 100th procedure milestone and look forward to many more successful surgeries to come.”