Michael Barbella10.05.20
There’s no going back now. The robots are here to stay.
For good.
And that’s good. Very good, actually.
Once purely science-fiction fodder, robots are becoming more embedded in society, increasingly assuming many routine, repetitive tasks. They help manufacture computer chips as well as automotive bodies, and move merchandise within Amazon’s gargantuan warehouses.
In healthcare, artificial intelligence algorithms, deep learning systems, and neural networks are being used to advance cancer detection, skin lesion screening, and acu-te kidney injury forecasting. Inside the operating room, robotic systems are teaming up with computer-aided navigation to improve precision and facilitate minimally invasive approaches.
Millions of robot-assisted procedures have been completed worldwide since the technology went mainstream in 2000. Robots are gaining popularity within orthopedics as surgeons embrace enhanced methods of bone preparation and implant placement. At least half of the planet’s largest orthopedics manufacturers have robotic systems at their disposal and are battling for share in the multi-billion-dollar robotic surgery market.
ODT’s March/April feature “Rise of the Robots” details the various trends and challenges shaping this dynamic up-and-coming market. Dan Cipolletti, global marketing communications manager for Corin Ltd., was among the experts interviewed for the story. His full input is provided in the following Q&A.
Costs in the episode of care—In the U.S., with the Affordable Care Act, some hospitals are subject to bundled payments, meaning they are paid a flat fee for all interactions with the patient within the 90-day window of surgery. Using robotics to improve outcomes may lead to less patient re-admittance, physical therapy demand, and also shorter hospital stay.
Accessibility/information—We are in the new age of technology and innovation, and the medical industry is starting to see the benefits.
Barbella: What challenges current exist in robotic surgery (pertaining to orthopedic procedures)?
Cipolletti: Adoption rate. The orthopedic community is often hesitant to change, and new procedures or technology will be approached with caution. But now [that] more clinical papers are coming out validating the technology and competition is rising, robotics in orthopedics is set to grow at a tremendous rate.
Cost. A lot of robotic platforms may cost a hospital up to $500,000 up front, with annual maintenance and service charges.
Barbella: What benefits/advantages does robotic surgery offer to patients (with damaged joints or other orthopedic-related problems) as opposed to traditional surgery?
Cipolletti: Regarding Corin’s robotic platform, [there is] less blood loss, which may lead to a quicker recovery; and no IM violation, so there’s less risk of embolism. Precision bone cuts allow for better joint alignment, which helps improve overall stability and longevity. Robotic ligament balancing helps maintain proper soft tissue balance for TKR. Soft tissue balance has been shown to improve overall patient satisfaction and reduce pain.
Barbella: Why is robotic surgery not yet the standard of care in orthopedic procedures? What will it take for these kinds of procedures to be the standard of care?
Cipolletti: For total hips, there is a perception that the procedure is already good enough—small revision rate, high patient satisfaction. Robotics doesn’t really have a proper solution to any THR problems yet. Total knees, I believe we will get there. It takes a while for the industry to change. Usually you need about 10 years’ worth of published data.
Barbella: What kinds of orthopedic procedures is robotic surgery most effective—knee, hip, extremities, trauma? Are there any kinds of injuries in which it is not effective? If so please explain.
Cipolletti: Robotic surgery is widely effective in spine surgery. Precision is key here and robotics is synonymous with precision. Knee replacement procedures have the most opportunity for improvement with robotics.
Barbella: Please discuss robotic surgery’s role in orthopedics in the next decade.
Cipolletti: It’s important to note that no system is “fully robotic,” where the robot is performing the surgery autonomously. All current procedures are robotic-assisted: where the robotic element is guided by the surgeon. So, the surgeon is always in control. It’s likely to remain that way, for many obvious reasons.
For the next decade, the total joint industry is forecasted to grow by a significant amount [due to] Baby Boomers getting older, more access to orthopedic facilities, and people living longer in general (arthritis is not going anywhere). Robotics, especially for Knee and Spine, will continue to gain market share and be a primary driver for orthopedic company and hospitals sales growth.
Barbella: What factors will most significantly impact robotic surgery and its development in orthopedics in the coming years?
Cipolletti: Publications of peer-reviewed clinical data will be the primary driver for widespread adoption. Also, advanced knowledge and continued innovation.
For good.
And that’s good. Very good, actually.
Once purely science-fiction fodder, robots are becoming more embedded in society, increasingly assuming many routine, repetitive tasks. They help manufacture computer chips as well as automotive bodies, and move merchandise within Amazon’s gargantuan warehouses.
In healthcare, artificial intelligence algorithms, deep learning systems, and neural networks are being used to advance cancer detection, skin lesion screening, and acu-te kidney injury forecasting. Inside the operating room, robotic systems are teaming up with computer-aided navigation to improve precision and facilitate minimally invasive approaches.
Millions of robot-assisted procedures have been completed worldwide since the technology went mainstream in 2000. Robots are gaining popularity within orthopedics as surgeons embrace enhanced methods of bone preparation and implant placement. At least half of the planet’s largest orthopedics manufacturers have robotic systems at their disposal and are battling for share in the multi-billion-dollar robotic surgery market.
ODT’s March/April feature “Rise of the Robots” details the various trends and challenges shaping this dynamic up-and-coming market. Dan Cipolletti, global marketing communications manager for Corin Ltd., was among the experts interviewed for the story. His full input is provided in the following Q&A.
Michael Barbella: What factors/trends are driving the robotic surgery market in orthopedics?
Dan Cipolletti: Just like any industry, follow the money. There are a few factors to consider:
Costs in the episode of care—In the U.S., with the Affordable Care Act, some hospitals are subject to bundled payments, meaning they are paid a flat fee for all interactions with the patient within the 90-day window of surgery. Using robotics to improve outcomes may lead to less patient re-admittance, physical therapy demand, and also shorter hospital stay.
Accessibility/information—We are in the new age of technology and innovation, and the medical industry is starting to see the benefits.
Barbella: What challenges current exist in robotic surgery (pertaining to orthopedic procedures)?
Cipolletti: Adoption rate. The orthopedic community is often hesitant to change, and new procedures or technology will be approached with caution. But now [that] more clinical papers are coming out validating the technology and competition is rising, robotics in orthopedics is set to grow at a tremendous rate.
Cost. A lot of robotic platforms may cost a hospital up to $500,000 up front, with annual maintenance and service charges.
Barbella: What benefits/advantages does robotic surgery offer to patients (with damaged joints or other orthopedic-related problems) as opposed to traditional surgery?
Cipolletti: Regarding Corin’s robotic platform, [there is] less blood loss, which may lead to a quicker recovery; and no IM violation, so there’s less risk of embolism. Precision bone cuts allow for better joint alignment, which helps improve overall stability and longevity. Robotic ligament balancing helps maintain proper soft tissue balance for TKR. Soft tissue balance has been shown to improve overall patient satisfaction and reduce pain.
Barbella: Why is robotic surgery not yet the standard of care in orthopedic procedures? What will it take for these kinds of procedures to be the standard of care?
Cipolletti: For total hips, there is a perception that the procedure is already good enough—small revision rate, high patient satisfaction. Robotics doesn’t really have a proper solution to any THR problems yet. Total knees, I believe we will get there. It takes a while for the industry to change. Usually you need about 10 years’ worth of published data.
Barbella: What kinds of orthopedic procedures is robotic surgery most effective—knee, hip, extremities, trauma? Are there any kinds of injuries in which it is not effective? If so please explain.
Cipolletti: Robotic surgery is widely effective in spine surgery. Precision is key here and robotics is synonymous with precision. Knee replacement procedures have the most opportunity for improvement with robotics.
Barbella: Please discuss robotic surgery’s role in orthopedics in the next decade.
Cipolletti: It’s important to note that no system is “fully robotic,” where the robot is performing the surgery autonomously. All current procedures are robotic-assisted: where the robotic element is guided by the surgeon. So, the surgeon is always in control. It’s likely to remain that way, for many obvious reasons.
For the next decade, the total joint industry is forecasted to grow by a significant amount [due to] Baby Boomers getting older, more access to orthopedic facilities, and people living longer in general (arthritis is not going anywhere). Robotics, especially for Knee and Spine, will continue to gain market share and be a primary driver for orthopedic company and hospitals sales growth.
Barbella: What factors will most significantly impact robotic surgery and its development in orthopedics in the coming years?
Cipolletti: Publications of peer-reviewed clinical data will be the primary driver for widespread adoption. Also, advanced knowledge and continued innovation.
