Doctors' robot reduces spine surgery risk

Surgeons have been using GPS-based devices for some time, but a Sydney operating theatre has been fitted with the medical equivalent of park-assist.

It's a leap forward, says neurosurgeon Dr Jonathon Ball, who is using the new robotic system to make his already exacting spine operations more precise.

Apart from reducing risk and improving accuracy, the Israeli-designed Renaissance guidance system improves recovery time and reduces pain.

Dr Ball and orthopaedic surgeon Dr Brian Hsu use it to position a drill guide before they insert screws and rods that stabilise deformed, degenerated or injured spines.

The system takes away the need to drill holes freehand, says Dr Ball, who is head of neurosurgery at Royal North Shore Hospital and also runs a private practice.

He and Dr Hsu bought the equipment, which is installed at North Shore Private and is the first system of its type in Australia.

They have each used it for about seven operations since it was installed in January.

Like most hi-tech medical equipment it's expensive, costing around $1 million for the full system.

Before each operation the doctors use a CT scan to program the device.

It moves along the spine to position the drill guide in a pre-planned sequence, ensuring each hole is in exactly the right place and at exactly the right angle.

It does away with the need for multiple X-rays used by surgeons in traditional spinal surgery.

Some operations need 20 to 30 holes, says Dr Ball. It's physically and mentally taxing work.

"We still do the surgery. We are still working the drill. But the robot guides us so the operation goes according to plan."

He says there is a 10 per cent error rate when drilling freehand, as he still does at the public hospital.

"I have never had a disaster, but I have done operations where I have had to go back and put a screw in a better position," he says.

"GPS-type devices have been common in surgery for some time. But this helps you drive the car as well," says Dr Hsu.

"It is not necessary for all spinal surgery, but it will be particularly beneficial for people who have difficult anatomy or unusual deformities.

"Like most boys we are excited about our new toy," he says.

"There is a lot of fear about back surgery in general. Nothing is 100 per cent safe. But this is a huge improvement."