This method is constantly gaining ground in the medical field, while it has already been applied to a significant number of adults and children, offering a number of advantages to both the patients and the doctors who use it, mainly the minimization of the possibility of medical error and the elimination of the possibility of causing neurological damage. The application of robotic surgery continues to expand continuously, although still few, specialized surgeons can apply it both in Greece and abroad.

How was it decided to apply to the spine?

“The three-dimensional and complex structure of the spine, as well as the multitude of its diseases, were and still are the cause of medical errors that leave many patients dissatisfied. In addition, the spine contains sensitive anatomical elements, such as the spinal cord and nerve roots, damage to which leads to extremely serious complications. Through the use of robotics, the international medical community is trying to minimize the severity of neurological complications by finding new, more targeted methods,” says Mr. Marios Lykissas Orthopedician, Director of the Orthopedic Clinic at Metropolitan Hospital.

How is robotic spine surgery performed?

“During the operation, the robot allows the surgeon to plan the procedure precisely, based on the anatomy, bone quality and desired correction of each patient’s spine, individually, features that can be seen on the CT scan performed either before or during the surgery and which is loaded into the robot’s computer. During the operation, the robot is a valuable assistant that facilitates the surgeon, as it precisely determines the insertion of the implants, thus increasing the success and efficiency rates,” he explains.

In which surgeries and for which spinal diseases can robotic technology be successfully applied?

“Robotic technology can be used in any operation where implants are to be placed or a section of bone removed from the spine. Specifically, in degenerative diseases such as spinal stenosis, spondylolisthesis, disc disease, spinal tumors, whether benign or malignant. It can also be applied to osteoporotic – and non-osteoporotic – fractures, as with the help of robotic technology, percutaneous and, in this way, bloodless stabilization of the spine is achieved,” emphasizes the expert.

Can it be used in patients with scoliosis or kyphosis?

“According to the new data of 2022, robotic navigation is leading the way in the treatment of spinal deformities, as it includes safety in terms of preventing complications, precision in terms of implant placement and efficiency, which translates into an excellent functional and aesthetic result for the patient. In fact, in the last six years, at the Metropolitan Hospital, more than 200 patients with spinal deformities have been treated with the help of robotic navigation,” he says.

What are the unique advantages it presents?

“Compared to conventional techniques, robotic spine surgery significantly reduces surgical time, ensures precision in the percutaneous placement of implants, while at the same time minimizing hospital stay, which even in the most serious cases does not exceed 3 days, while in the other cases an overnight stay is needed. In addition, it minimizes neurological complications, significantly reduces intraoperative blood loss and therefore the need for a transfusion, as well as the patient’s intraoperative and postoperative stress, while showing very low rates of perioperative morbidity,” he points out.

Are there any risks from this particular operation?

“The risks of such an operation have been reduced to a minimum. Meanwhile, the postoperative recovery time has also been reduced to a minimum. It would not be an exaggeration to say that robotic navigation in the hands of experienced surgeons enables significant correction of the deformity, which can even reach 100%, i.e. complete correction.
Of course, the choice of the surgeon is also important. The patient needs to ask the right questions about their problem, know when is the best time to operate and what are their non-surgical alternatives.

Using the Excelsius GPS robotic system, the most modern achievement in robotic surgery worldwide, with which my team works, the success of the operation is ensured. After specific screening procedures, it is used only by certified robotic surgeons supported by a specially trained team of nurses and technicians. Every day, they are asked to implement more and more high-difficulty operations, significantly increasing success rates and reducing morbidity rates,” concludes Mr. Lykissas.