What is haptic technology in Mako robotic surgery? Dr. Muhsin Dursun explains.
Haptic technology is an advanced control system that helps surgeons work within the boundaries of a predetermined surgical plan during Mako robotic arm-assisted knee and hip replacement surgeries. Working in conjunction with a patient-specific three-dimensional plan, this technology supports the precise execution of bone cuts in the planned area, the preservation of surrounding healthy tissues, and the more accurate placement of the prosthesis.
What does haptic technology mean?
The word “haptic” refers to feedback felt through touch and movement. The vibration you experience when you touch your phone screen in everyday life is a simple example of haptic feedback.
In the Mako robotic surgical system, haptic technology is used for a much more advanced purpose. The system transforms the personalized plan created before the surgery into virtual boundaries. As the surgeon uses the robotic arm, these boundaries help to physically restrict the surgical instrument from going outside the planned area.
This feature is called AccuStop™ haptic technology in the Mako system. The system uses a combination of three-dimensional CT-based planning, haptic boundaries, and data obtained during surgery.
How do virtual boundaries work in the Mako system?
The Mako robotic surgery process typically begins with an evaluation of the patient’s joint structure using computed tomography (CT) images. These images are then used to create a three-dimensional model of the knee or hip joint.
The surgeon is using this model;
- The size of the prosthesis,
- The placement angle of the prosthesis,
- The area of bone that needs to be removed,
- Joint balance and ligament condition.
Plans before the surgery.
The prepared plan is transferred to the robotic system during the operation. Haptic technology also creates an invisible safety zone around the area where the bone cuts will be made.
What happens if the surgical instrument goes off plan?
When the surgeon directs the robotic arm outside the planned area, the system restricts movement. In other words, the robot does not perform the surgery on its own; it helps the surgeon keep their movements within the defined safe area.
Therefore, haptic technology can be thought of as a virtual firewall guiding the surgical instrument under the surgeon’s control.
Why is haptic technology important?
In traditional prosthetic surgeries, the surgeon’s experience, the measuring instruments used, and mechanical cutting guides are of great importance. In Mako robotic surgery, however, this experience is combined with a digitally prepared plan and haptic boundaries tailored to the patient’s own anatomy.
More Controlled Bone Cuts
Haptic boundaries help ensure that work is performed only within the bone area specified in the surgical plan. This allows for more controlled execution of the cutting distance and angle.
According to Stryker data on Mako Total Knee, three-dimensional CT-based planning and haptic boundaries support more precise execution of the surgery according to the prepared plan.
Protecting Surrounding Healthy Tissues
The knee joint is surrounded by ligaments, muscles, tendons, blood vessels, and nerves. Controlling the range of motion of the surgical instrument during bone cutting can help protect the surrounding healthy soft tissues.
Studies on the Mako system have reported that robotic arm-assisted applications performed within haptic limits may be associated with less soft tissue damage compared to manual methods.
Placement of the Prosthesis in the Planned Location
Choosing the right size knee replacement is not enough. The angle and position at which the prosthesis is placed in the bone are also important for joint movement.
Haptic technology helps the surgeon to more precisely execute the prosthesis placement plan prepared before surgery on the bone. The goal is to position the prosthesis in a way that is appropriate to the patient’s anatomy, joint structure, and surgical plan.
Is Haptic Technology Performing the Surgery?
No. The Mako system or haptic technology does not perform the surgery on its own.
The orthopedic surgeon plans the surgery, directs the robotic arm, makes the bone cuts, and places the prosthesis. The robotic system provides the surgeon with measurement, planning, visual guidance, and movement restriction support.
In short, the surgeon is always in control. Haptic technology is not a system that replaces the surgeon’s hand; it is a technological support tool that helps the surgeon to execute their plan in a more controlled manner.
Is haptic technology used in the same way for every patient?
Each patient has a different bone structure, leg alignment, amount of joint wear, and ligament balance. Therefore, in Mako robotic surgery, there is no single standard plan that applies to everyone.
A patient-specific plan is created using a three-dimensional model derived from computed tomography images. Haptic margins are also determined according to this personalized plan. Thus, the surgical procedure is performed not only according to general measurements but also taking into account the patient’s own anatomical characteristics.
In which surgeries is haptic technology used?
Within the scope of the Mako SmartRobotics system, haptic technology is used;
Robotic Total Knee Replacement
It can be used in patients who have advanced osteoarthritis in multiple sections of the knee joint and who are planning to undergo total knee replacement.
Robotic Partial Knee Replacement
It can be used in partial knee replacement surgeries for suitable patients whose osteoarthritis affects only a specific part of the knee, aiming to preserve as much healthy bone and tissue as possible.
Robotic Hip Replacement
It can be used in hip replacement surgeries to help prepare the socket portion of the prosthesis at the pre-planned angle and position. Mako’s haptic technology supports the surgeon in working according to the CT-based plan.
Does Haptic Technology Guarantee Surgical Success?
No single surgical technology guarantees complete success. The outcome of the treatment depends on…
- The patient’s age and general health condition,
- Bone quality,
- The level of damage to the joint,
- The surgeon’s experience,
- Post-operative physical therapy,
- Patient compliance with recommendations
It depends on many factors, such as these.
Haptic technology offers surgeons more data, a more controlled range of motion, and personalized planning capabilities. However, the decision to operate should be made not solely based on the technology used, but also on the patient’s examination and radiological evaluations.
Mako Robotic Surgery and Haptic Technology in Adana
Patients considering knee or hip replacement surgery due to osteoarthritis should first undergo a detailed orthopedic examination. Not all knee pain necessitates replacement surgery, and not all patients meet the same criteria for robotic surgery.
In Adana, when evaluating Mako robotic knee or hip replacement surgery, the patient’s complaints, joint movements, X-rays, and other imaging results are examined together. For suitable patients, surgical options are evaluated with personalized three-dimensional planning and haptic technology support.
