Digital operating room promises improved joint surgeries

The first Canadian arthroscopic digital operating room will shorten patient recovery time from joint replacement surgery while offering them better quality of life for years to come, according to the hospital’s director.

The Toronto Western

Hospital introduced a digital O.R. to its musculoskeletal and arthritis program a month ago. The addition, using custom designed technology from Andover, Mass.-based Smith & Nephew Inc., is a step towards the hospital’s vision of using IT-based solutions at the forefront of development of its surgical techniques, says the hospital’s director of musculoskeletal health and arthritis program Dr. Nizar Mahomed.

The operating room will use Smith & Nephew’s software and surgical instrumentation, which will allow health-care providers to take digital picture that more accurately define the positioning and insertion of knee replacements and hip replacements. Mahomed says. This should turn such joint replacement surgeries into a much less invasive procedure. Arthroscopy refers to the exanination of the inside structures of a joint.

“”Traditionally it’s a fairly large surgical incision. You have to do that in order to expose enough of the joint to accurately place the implant,”” he says. “”If we’re using the computer and instrumented components to place the components of the joint replacement, then we’d be able to do it through smaller incisions.””

A smaller incision should speed both patient recovery and ensure the longer function of the joint, he says.

The added precision and the increased surgeon control of O.R. room tools benefits the patient in another way, says Smith & Nephew project development manager Marc Filerman: shorter surgery time.

“”It means decreasing the amount of time that a person is under anaesthetic, which is definitely a good thing,”” he says.

Filerman says the digital O.R. can also lead to improved patient care by making inter-departmental communication within the hospital possible. For the first time ever, it allows for bi-directional real time audio and video links between departments, which gives the operating staff access to more information while performing surgery.

“”Let’s say someone is having an interoperative biopsy. The results of that biopsy are not directly available to the surgeon. By using a bi-directional video and audio directly in the operating room, the surgeon can now communicate directly with the pathologist,”” Filerman says.

Access to digital X-rays and MRIs is also possible in the digital O.R. which is of a huge benefit in the orthopaedic reconstructive surgeries Toronto Western Hospital frequently performs, Filerman says.

“”Previously X-rays were only accessible on film. The surgeon would have to leave the sterile field to walk over to the light box and see them,”” he says. “”Now, the digital O.R. provides a platform to allow those images to be displayed on any monitor in the operating room.””

The Toronto Western Hospital staff plan to use its new O.R.’s multimedia audio video system to advance its position as a leading teaching hospital, Mahomed says.

The hospital plans to use the equipment to hold teleconferences with medical and learning institutions all over the world. It also hopes to run some continuing medical education course components from this operating room and telecast live surgical procedures to students, he says.

Smith & Nephew have had an ongoing relationship with the University Health Network, of which Toronto Western Hospital is part, for years, says Filerman. The trust built up during those yearsm combined with the technology the company presented the hospital, made a partnership an obvious choice, he adds.

Filerman says that although there is a growing interest in the medical field in this type of technology, the digital O.R. is still in the early adopter stage in both the U.S. and Canada.

Mahomed says it won’t stay that way for long and is an area in which the whole University Health Network sees future growth.

“”I think as with anything with technology, the rate of development is accelerated. So I would expect that over the next three to five years this is going to become a more significant aspect of how we would consider doing surgery,”” he says.

The digital O.R. is not a static technology, says Filerman. It is in fact a platform that can be used to adding new technologies and improving operating processes as time goes on.

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