ERH gets high-tech with robotic-assisted surgery


EVANSTON — Residents of southwest Wyoming now have a new option when considering total knee replacement surgery. Evanston Regional Hospital recently began offering OMNIBotics advanced robotic-assisted surgery as an alternative to traditional knee replacement.

Dr. Micah Pullins, orthopedic surgeon at ERH, said the primary benefit of the robotic-assisted option is a greater level of precision and accuracy, which can both extend the life of the replacement components and increase patient satisfaction with better joint function and a more natural feel.

ERH CEO Jeremy Davis said the acquisition of the new system was part of the hospital’s quest to be the healthcare provider of choice for southwest Wyoming. 

The OMNIBotics system allows the surgeon to map out the anatomy of each individual knee in real-time at the start of each operation using probes that “paint” over the surfaces of the bones in the joint itself. The image created from the mapping is pictured on a large screen so the physician can see the anatomy virtually, complete with unique deformities, and use this image to map out the precise measurements of cuts to the bones and test the replacement components for best fit. 

The computerized images also allow the surgeon to determine the exact center of rotation of the joint and the alignment of ligaments and tendons. 

This precise mapping of each patient’s knee joint means there is less re-cutting required to get the cuts just right. After the computer images are generated and the cuts mapped, the robotic elements attached to the actual knee come into play again. Sensors that pinpoint the exact position of the knee allow the surgeon to make bone cuts precisely where needed. 

Pullins said with traditional knee replacement surgery the alignment has to be ensured with either external clamping, which is generally less accurate, or rods placed internally within the femur itself. The robotic-assisted knee replacement allows for greater accuracy without the need to drill holes into the femur for the rod placement. Pullins described the OMNIBotics approach as “less barbaric” than traditional knee replacement. 

The life of the replacement is extended to between 20 and 30 years because of the better fit made possible by the mapping, and the patient satisfaction is also increased because of the more natural feel. An additional advantage is that no CT or MRI scans are required preoperatively because the real-time mapping makes them unnecessary. “It means there are less delays in getting the surgery done,” said Pullins. 

Athough the operation is assisted by the robotic components, the human surgeon maintains complete control. Additionally, a representative from OMNIBotics is in the operating room the entire time to ensure the unit is functioning appropriately and to assist with the mapping and navigation. 

Although the OMNIBotics system is new to ERH and relatively new to the United States, Jeff Sims, OMNI representative, said the system has been used in Europe for nearly two decades. More than 17,000 procedures have been done since OMNI received FDA approval about five years ago. 

Pullins said there is a high demand for total knee replacement surgery in the area due to the types of jobs many people hold. “People in this area put up with a lot,” he said, “so by the time they come in to see me a total knee replacement is almost the only option left.” 

He said the transformation in people’s lives made possible by knee or other joint replacement is the best part of his job.

“I’d say about 97 percent of the people who choose to have this done are happy with their decision,” said Pullins. “It absolutely changes lives.”

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