Mako SmartRobotics™ is a versatile, multiplatform system that currently assists surgeons Total Hip, Total Knee, and Partial Knee replacements.
Mako SmartRobotics™ has a history dating back to 2006. During that time, over 400 peer-reviewed articles have been published on the potential clinical advantages of Mako. In 2023 Mako SmartRobotics recently passed the 1 million global procedure milestone. [1-3]
It’s a mutltiplatform robot, meaning it can do numerous tasks rather than being able to do only one type of joint. Currently it is able to assist surgeons perform Total Hip, Total Knee and Partial Knee Replacements, and more recently shoulder replacements and spine surgery.
So, how does the technology work?
Before surgery Dr Bali arranges a CT scan prior which is sent to the states so he has a virtual 3-Dimensional model of the affected joint, as well as its relationship to other joints, before planning the hip or knee replacement. For hips the association for how the pelvis moves during sitting and and standing is also incorporated. The joint replacement is placed virtually on this 3D model looking at the patient’s size and shape of the bone.
During surgery, the first thing to do is match the patient’s real life anatomy with the robots 3 dimensional model by referencing at least 30 points on the joint which need to measure within 1mm of the robots virtual 3D model. Once the dots match up the robots goes ‘green’ and is now live to plan and execute the surgery. Dr Bali looks at the preoperative plan and may adjusts it sightly depending on the feedback from the robot on how tight or loose the ligaments or the patient’s anatomy, and when the joint replacement has been virtually adjusted to the optimal position, the robot arm is brought in to do the cuts and execute the plan. The robot has patented haptic boundaries, which means that the saw or burr can only go within tightly constrained boundaries, so that only the essential bone is removed with the potential of less damage to the surrounding tissues. Some patients ask if Dr Bali is even in the room, but it’s important to note that the surgeon is always in control of the robotic arm (and in theatre!) [4-6]
Overall achieving improved accuracy is relevant for everything we do in surgery. Robotics is a modern way we can deliver this, with potential benefits to both the surgical team and patient recovery.
