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In Zephyrhills, a robotic arm guides knee replacement surgery

ZEPHYRHILLS — In the past, when his patients' knees started to give out, Dr. Randy Knight advised a full knee replacement.

"The partial knee (operations) failed," the orthopedic surgeon said. "We weren't putting them in perfectly. They were too tight or too loose."

When he learned about a new minimally invasive procedure that uses a robot to resurface part of the knee, he was skeptical at first. But after researching it he was so impressed he got another surgeon to do it for his 90-year-old father at a hospital in Naples.

"I watched my friends go through long periods of rehabilitation," said Dr. Coyne Knight, a retired urologist who was reluctant to have traditional knee replacements. "I wasn't willing to devote six months of my life to rehab and painful living."

Less than a month after robotic surgeries on both knees, he was able to toss out his walker and cane.

On March 7, his son performed the same surgery at Florida Hospital Zephyrhills using the same system, putting the hospital in line with the rising use of robotic surgery to reduce pain, blood loss and recovery time.

Called MAKOplasty, it allows surgeons to position implants precisely by providing a plan that details the techniques for bone preparation and customized implant positioning using a CT scan of the patient's knee. During the procedure, the system creates a 3-D live action, virtual view of the patient's bone surface and correlates the image to the preprogrammed surgical plan, hospital officials said.

The robotic arm sends feedback to the surgeon to know about where to cut and limits bone preparation to the diseased areas. It also shows precisely where to put the implant in each patient.

"It puts on the brakes and says, 'Don't go there,' " Dr. Randy Knight said. "It helps you color within the lines, so to speak."

In most cases, it requires no overnight hospital stay.

"I'm able to walk my dog," said Burvellee "Bev" Cook, 83, who was the first to have the surgery at Florida Hospital Zephyrhills on March 7. She still has some pain but expects that to disappear soon.

Not everyone is a candidate for the surgery, however. Only those with earlier stage osteoarthritis, which affects the inner part of the knee, are eligible. Surgeons decide that based on X-rays and exams.

Florida Hospital Zephyrhills is the only hospital in Pasco or Polk to offer the 5-year-old MAKOplasty procedure, which Tampa General Hospital began offering last year.

However, it's not the only one using robots to help with surgeries.

In 2007, Community Hospital in New Port Richey was the first hospital in Pasco, Hernando and Citrus counties to get a $1.25 million da Vinci Surgical System, which is used for gynecological and urologic operations.

Dade City's Pasco Regional Medical Center got the system last year and used it to remove a gall bladder and a pair of ovaries.

In 2009, the University of South Florida unveiled a $4 million center to train doctors to do robot-assisted surgery as part of a partnership with the California company Intuitive Surgical Inc., the developers of the da Vinci system.

Despite the use of the term "robotic surgery," surgeons still do the work, so training is critical.

In 2002, Plant High School teacher Al Greenway died after surgeons at St. Joseph's Hospital in Tampa accidentally cut two blood vessels while trying to use a da Vinci robot-assisted machine to remove his cancerous kidney.

Greenway's widow sued the hospital, accusing St. Joseph's of letting doctors inexperienced with the robot perform his surgery. The case was settled out of court. Intuitive Surgical was not a party to the lawsuit.

Orthopedic surgeon Knight trained at other hospitals and practiced on models and cadavers and with other doctors.

"The company won't sell you the machine until you know how to use them," he said.

In Zephyrhills, a robotic arm guides knee replacement surgery 03/24/11 [Last modified: Thursday, March 24, 2011 9:01pm]
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