Robotics competitions. STEM clubs. Drones. Self-driving cars. BB-8. Robots are here to stay (ok, maybe not BB-8). Throughout the world these automated, programmable machines are advancing knowledge, efficiency, and human accomplishment.

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Olympia Orthopaedic Associates surgeon Dr. Andrew Manista performed the first robotic-guided spine surgery on October 16, 2016.

The medical field is no exception. Robotic advancements throughout medicine are improving outcomes for patients every day. One example is the emergence or robotic-guided spine surgery using the Mazor Renaissance® Guidance System. This small robot is helping surgeons increase accuracy and precision compared to traditional free-hand surgeries. The systems uses 3D imaging and pinpoint, robotic guidance for incisions and surgical implant placements.

The Mazor Renaissance® Guidance System is gaining popularity with surgeons across the nation. In Washington state, the first robotic-guided spine surgery was performed just four months ago by Dr. Andrew Manista, an orthopaedic spine surgeon at Olympia Orthopaedic Associates. Dr. Manista’s team completed this historic procedure at Olympia’s Capital Medical Center on October 16, 2015.

“What’s so exciting about this new technology is how it allows me to do the type of surgery I love to do with increased precision,” shares Dr. Manista.

Two successful surgeries were completed that October day using the Renaissance® system. Since that day, Dr. Manista has performed more than 44 robotic-guided spinal surgeries. In addition, 16 surgeries have been performed by his colleagues Dr. Clyde Carpenter and Dr. Yoshihiro Yamamoto with plans for more in the future.

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Through precision 3D modeling, the surgeon and robot work as a team to accurately place all hardware and make all incisions during robotic-guided spine surgery.

Both surgeons and patients see benefits from the robotic-guidance system. Surgeons site increased precision including a significant decrease in errors in placing screws during surgical procedures. “Surgeons have placed over 100,000 screws using this technology, with accuracy of 98% or greater,” shares Dr. Manista. This increased precision in-turn decreases the potential for complications and repeat surgeries. In addition, exact, robotic-guided screw placement, helps facilitate smaller incisions, and therefore faster healing.

Physicians site the pleasant side-effect of faster surgeries, reducing time in the OR for doctors and nurses. The Renaissance® also reduces the need for additional imaging equipment in the OR giving doctors more room to maneuver. For patients, shorter surgeries mean less anesthesia and reduced time with open wounds, lowering infection risk. The Renaissance® also reduces need for fluoroscopy (an x-ray “movie” used during precision surgery). “Using the robot allows our surgeries to be minimally invasive, with greater certainty, and less radiation,” says Dr. Manista.

The surgical team engages in extensive planning prior to the physical procedure. This involves spinal imaging and coordination among all team players. The Mazor Renaissance® Guidance System is now a part of the team.

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Shorter surgeries, increased accuracy, and less exposure to radiation are just a few of the benefits of using the Renaissance® robot during spine surgery.

A pre-operative blueprint of the patient’s spine is created using 3D imaging captured by doctors and the Renaissance® software. The software’s 3D modeling allows surgeons to plan for a patient’s unique anatomy, any previous surgical hardware or deformations and, the proper sized implant. The team can essentially do a “dry run” of the procedure in virtual reality prior to the actual surgery.

The next step is to choose a mounting platform for the robot. The system includes four different rigid platforms that surgeons attach securely to the patient’s body during surgery. The platforms allow the robot to interact precisely with a patient’s spine. By ensuring secure attachment it to the patient’s body, even slight movements during the procedure will not alter the precision of Renaissance®.

As surgery begins, the robot “pairs” the pre-operative plan stored in it’s software and the physical location of the patient’s spine. Once the blueprint and physical anatomy are linked by the robot, it can then guide the surgeon’s tools to the precise location of each incision or hardware placement.

Renaissance® may be small, but it is accomplishing big things for patients and doctors. Able to sit in the palm of your hand, the robot includes several “arms” that attach based on the surgical plan. The surgeon instructs the robot to select a specific arm and indicates the location for the next incision, for example to the L4 vertebrae. This precise system ensures the surgeon, with the robot’s help, is following the surgical plan exactly.

Dr. Manista was a music and double bass performance major in college and shares a musical analogy to help illustrate how the Renaissance® is part of the surgical orchestra. “Surgery is like a symphony with a first, second, and third movement. The first and second movement go quickly but the third movement is the hardest and longest – placing the hardware,” he says. “The Renaissance® makes the third movement take so much less time and flow more smoothly for everyone.”

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The neuro-surgery team at Oly Ortho now includes the Mazor Renaissance® Guidance System robot.

The Spine and Neurosurgery group at Olympia Orthopaedics Associates, and others throughout the nation, are collecting data with each surgery. The current results show:

  • 1/3 shorter hospital stays
  • Half the surgical revisions of traditional surgery
  • All screws safely placed according to pre-operative plan

“This technology is quickly becoming the standard of care because of the precision,” explains Dr. Manista. “It allows us to reach goals in patient care set by our founders over 30 years ago. It’s truly a game changer.”

Dr. Manista and his colleagues at the Oly Ortho Westside Clinic are eager to share the Mazor Renaissance® Guidance System and discuss if it’s the right fit for you.

Olympia Orthopaedic Associates
3901 Capitol Mall Drive SW, Olympia


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