Xizang orthopedic doctors and the team of the Sixth Hospital perform simultaneous surgery: "This is the first robot assisted surgery in my career" robot | orthopaedics | team

"It's my first time to contact robot surgery, and the precision and precision brought by this kind of digitalization is really shocking." Ciren Lunzhu, 43, is a deputy chief physician of orthopaedic surgery at Shannan People's Hospital of the Xizang Autonomous Region. At 11:40 a.m. on June 5, after finishing the first robot assisted total knee arthroplasty in my career, she reviewed her past 300 or 400 operations. Lunzhu said frankly, especially in plateau areas, robot assisted surgery can make surgery safer, and more effectively solve the problems of doctors' "uncertainty" and "uncertainty".

On June 5, the 5G remote synchronous multi center robot hip and knee arthroplasty in five places led by Professor Zhang Xianlong from the Orthopaedics Department of Shanghai Sixth People's Hospital was carried out in Shanghai Sixth People's Hospital, Haikou Orthopaedics and diabetes Hospital of Shanghai Sixth People's Hospital, Quzhou Orthopaedics and Traumatology Hospital, Shannan People's Hospital, and the First Affiliated Hospital of Xinjiang Medical University. Professors Zhang Changqing, Zhang Xianlong, Wang Qi, and Shen Hao from the orthopedics department participated in this remote guidance.

At 10:30 a.m., the Haikou Orthopaedic Department of the Sixth Hospital and the diabetes Hospital, with the help of remote technology, started the first remote robot assisted total hip replacement operation based on 5G network. In traditional artificial joint replacement surgery, even experienced doctors can generally only achieve 85% accuracy, while cultivating a doctor who can perform surgery on stage takes at least 5 years. The emergence of robotic surgery is a revolutionary technology for joint surgery, which not only greatly accelerates the training cycle of doctors, but also helps doctors complete each surgery in a standardized and precise manner, bringing faster recovery to patients with less trauma, and surgical accuracy can approach 100%. As of 12:00 noon, the monitoring screen at the Remote Medical Center of the Sixth People's Hospital in Shanghai shows that all five joint replacement surgeries, located far and wide, have been successfully completed.

The knee joint is the largest joint in the human body, with heavy load and high mobility. Joint cartilage is prone to wear and damage, leading to degenerative changes in the knee joint and resulting in knee osteoarthritis. This disease is also one of the important reasons for what people call "old cold legs".

At present, 60% of the people over 55 years old in China have imaging changes of knee joints, while the incidence rate of knee osteoarthritis among the elderly over 65 years old is as high as 85%, which has brought a heavy burden to patients, families and society. It can be foreseen that with the increasing aging of the population in China, the incidence and number of patients with knee osteoarthritis will gradually increase. Artificial joint replacement, as a mature and effective treatment method for severe osteoarthritis, is increasingly widely used. Single condylar joint replacement surgery is a new minimally invasive surgery compared to total knee joint replacement surgery. It only replaces the damaged part and performs surface replacement on the inner or outer compartments of the knee joint to replace the damaged cartilage surface of the knee joint. This technique does not require the removal of the anterior and posterior cruciate ligaments, preserving the proprioceptive sensation and joint function of the knee joint. Zhang Xianlong vividly said, "Just like car tires, the knee joints of the human body can also experience wear and tear. When a tire leaks due to a hole, should it be repaired or replaced as a whole? Single condyle replacement surgery is like repairing a tire, repairing where it is damaged. This can not only cure the disease, but also maximize the preservation of the patient's knee and preserve more of their own tissue. After the surgery, the patient's knee joint function will be closer to normal."

Precision positioning, minimally invasive technology, and personalized design - Zhang Xianlong stated that compared to traditional surgery, robot assisted surgery has significant advantages in the field of hip and knee replacement surgery. On the basis of 3D modeling, doctors can intuitively understand the positioning, angle, size, and bone coverage data of the patient's joint prosthesis in 3D space in advance, and design and simulate personalized surgical plans based on this. "With the assistance of robots, doctors have broken through the previously limited blind spots in cognition and vision, and can more accurately meet patients' needs. At the same time, with the integration of human-machine interaction, doctors' standards for hip and knee joint replacement are constantly being updated."

It is reported that the Sixth Hospital of the city successfully completed the first robot assisted knee joint unicompartment replacement surgery in China in September 2016. As of now, the six hospitals in the city have implemented over 1500 robot assisted joint replacement surgeries, including nearly 500 total hip replacement surgeries and about 1000 total knee replacement surgeries. According to the follow-up results of existing cases, the clinical results of robots in assisting hip and knee replacement surgery are superior to traditional surgery.

In response, Zhang Changqing, Director of the National Orthopedic Medical Center and Head of Orthopedics at the Sixth Hospital, stated that "human-machine interaction" is a trend for the development of orthopedics in the future. On the one hand, robot assistance has shortened the growth curve of doctors; On the other hand, clinical technology requirements continue to promote the iterative updating of robots. The application of 5G telemedicine in simultaneous surgery at multiple points and centers reflects the demonstration and leading role of the National Orthopedic Medical Center of the Sixth Hospital, which helps to further amplify the radiation effect of high-quality medical resources in the national team and promote coordinated development in remote areas. He introduced that in the future, the Sixth Hospital will actively leverage the effectiveness of "smart orthopedics", leading orthopedic surgery towards minimally invasive, digital, and standardized development, and enhancing the independent innovation ability and international competitiveness in the field of intelligent orthopedic diagnosis and treatment. At the same time, we will replicate and promote the experience to more grassroots hospitals, in order to further enhance the medical service level of national regional medical centers.