RIO gets warm welcome at CCH

Hospital celebrates addition of cutting-edge robotic technology
Feb. 07, 2013 @ 06:17 PM

Central Carolina Hospital is embracing the rise of the machines.

About 30 community members and hospital employees gathered at the hospital Thursday afternoon to celebrate the hospital's newest team member: a robotic arm that goes by the name RIO.

Short for Robotic Arm Interactive Orthopedic System, RIO will be controlled by surgeons and will allow them to perform tricky procedures, like partial knee replacements, that mere human hands can't do with equal consistency. Plus, said Andy Bush, an orthopedic surgeon on staff at CCH who is now the only one who would use the new machine, surgeons have trouble with partial knee replacements because they can't see everything and often have to rely on feel alone, which is imperfect.

"With the robotic arm, I can only go as far as the robot lets me go," he said. "If I push too hard, it tells me. And if I push way too hard, it shuts down."

Only eight hospitals in all of North Carolina have this technology, and CCH is the first one in the Sandhills region to get one, according to hospital officials. In addition to partial knee surgeries — which are less invasive than traditional knee replacements and are meant for people with early or mid-stage osteoarthritis — the hospital also plans to use the technology for hip replacement surgeries.

Paul Kostansek, a representative from MAKO Surgical Corp., which manufactures the arm, compared the technology to a GPS system because surgeons like Bush will be able to map out a surgical plan and boundaries that, thanks to antennas and 3D-imaging, the robot will force the surgeon to stay inside. Unlike a GPS, he said, there's no route correction because the robot won't let the surgeon "drive" his tools off course in the first place — whether because of an accident or inexperience.

"If you cough, or breathe heavy, it's not going to let you push," he said.

Several of those in attendance Thursday took turns clearing out a practice knee joint. And just as promised, the drill bit bounced back whenever it hit one of the invisible barriers enforced by the computer system, which showed a green area on the screen that turned white once everything the surgeon had pre-programmed into the image had been turned to dust.

Although amateurs could carry out the actual drilling, Bush — who performs about 70 knee and hip replacements a year — said he's not worried about the machines taking his job just yet because a surgeon is still required to decide which areas to make off limits and which tools to use at which times, plus all the work before and after the surgery itself that a robot can't do. RIO will simply allow him to add partial knee replacements to his repertoires and to be literally more precise in his work than is humanly possible.

"Sometimes we're good, but sometimes we're not so good," he said, referring to surgeons in general. "And you guys know that when you get out (of the hospital). But this takes out a lot of that potential for error."

He said he's generally suspicious of new technology, but that the tools of orthopedic surgery haven't changed in about 50 or 60 years and could use some innovation. Plus, he said, these machines have been around for six years, in which time surgeons have performed about 20,000 surgeries and only reported about 1 percent of patients who had to return to the hospital.

"I feel comfortable offering it to the community," he said. "... I feel robotics is the next step."