Robot competition ramps up as orthopedic surgeons ponder a new standard of care


Robots in orthopedics are becoming more commonplace, as major market players including Stryker, Zimmer Biomet, Smith + Nephew and Johnson & Johnson have launched their own products for surgeons. 

Johnson & Johnson's orthopedic business, DePuy Synthes, received FDA clearance for its Teligen device in October, while Zimmer Biomet has continued to update its robotics profile in the hip and shoulder space. 

While robotic orthopedic procedures are still in their infancy, physicians report a myriad of benefits from the tools, including faster recovery times, fewer complications and less invasive procedures. 

"One of the largest challenges in adapting minimally invasive surgical techniques for spine surgery has been the high-dose radiation exposure required to execute a reliable and durable less invasive option," Saad Chaudhary, MD, a surgeon at New York City-based Mount Sinai Health System, told Becker's. "Now, with the advent of high-fidelity robotic platforms, the radiation exposure to the surgical team and patients can be significantly minimized, while delivering a highly accurate and successful surgical solution. This robotic technology will allow for a wider adaptation of less invasive surgical solutions across the country."

Many spine leaders, especially up and coming leaders who are new in the field, believe that robotic procedures are the future of the industry. 

Some surgeons, including Michael Gallizzi, MD, of Vail, Colo.-based The Steadman Clinic, are already logging upward of 100 robot-assisted spine surgeries. 

"Using the robot as a targeting mechanism and then passing the endoscope through the robot to be more accurate with some of our disease pathology treatments will be a game changer," Dr. Gallizzi said. 

Some more experienced surgeons in the field are more hesitant about using spine robots, when they have practiced for 30 or more years without the new technology. 

"Being adventuresome at a particular stage in one's career becomes less attractive; yet the physiological basis and technological improvements of these options have widened," Christian Zimmerman, MD, a surgeon at St. Alphonsus Medical Group in Boise, Idaho, told Becker's

Since these new robots are still relatively new on the scene, some surgeons are concerned about the lack of knowledge surrounding their long-term effects. 

"I think the jury is still somewhat out on the superiority of clinical outcomes with robotic surgeries versus conventional surgeries. But certainly I think we will see what the long-term data show, and certainly we will be able to get a lot more information from these surgeries and hopefully fine-tune the surgeries and make them even better in the years to come," Julius Oni, MD, medical director of orthopedics at Johns Hopkins Bayview Medical Center in Baltimore, told Becker's.

And since robots are still not commonplace in all practices, their prices remain high, with many spine robots costing as much as $1 million each for a practice to acquire. 

The procedures can also be more expensive for patients, as not all surgeons are trained to operate with robots yet. 

As more surgeons begin acquiring robots, this could start to drive prices down for practices and patients alike. 

And there is no doubt that the surgical robot market is becoming more saturated, as Becker's reported on 12 new practices that added robots this quarter. 

"In the future, we will most certainly move into the 'real' robotic age, when surgery takes full advantage of the robot's speed, precision and accuracy, and the surgeon transitions into the manager of the robot, using augmented reality and user interface principles proven to work in aviation. In this capacity, the robot will be the surgeon of the future," Bruce Gomberg, MD, surgeon at Falmouth, Maine-based Northern Lights Health, told Becker's. 

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