This robotic assistant has helped with more than 300,000 operations and is transforming the way doctors perform joint replacement surgeries.
In a demonstration lab at medical technology firm Stryker’s joint replacement division headquarters in Mahwah, New Jersey, a fake leg rests on an operating table. A technician stands at a computer while a nearby screen shows a 3D rendering of the prosthetic leg’s knee, each curve and indent of the joint accurate.
A light gray machine stands next to the table, with one large “arm” extending out, surgical tool in hand, ready to operate.
This is Mako Robotic-Arm Assisted Technology — Mako, for short — a robotic surgeon’s assistant that’s being used nationwide and around the world in total hip, total knee, and partial knee replacement surgeries.
This technology, first developed more than a decade ago, but acquired by Stryker in 2013, is an example of how robotics can make for more accurate, error-free surgeries — a technology that once only existed in science fiction, but is now scientific fact.
Surgeons who use this tool are able to view a comprehensive 3D image unique to their patient’s anatomy — in this case, it would be the knee in question — able to manipulate the image, seeing exactly where they need to operate.
This information is programmed into Mako, which through haptic technology, will only operate within the bounds dictated by the surgeon. If it gets too close to being out of bounds of a specific operation, the machine will automatically stop, making sure those accidental, surgical mistakes that can happen with just human hands, don’t occur.
“The clinical results speak for themselves,” Robert Cohen, vice president of Global R&D and chief technology officer at Stryker Joint Replacement, told Healthline during a tour of the New Jersey facility. “Surgeons are having such good success with Mako program — we know we’ve tapped into something that surgeons want. Surgeons want accurate placement. They want accuracy.”
Hip and knee surgeries are becoming increasingly common. The American Academy of Orthopaedic Surgeons reports that 2018 saw 1,432,491 total hip and knee replacement surgeries.
However, Cohen stressed that one factor that isn’t discussed enough is how many people are “dissatisfied” with their hip and knee replacement surgeries.
In the past, standardized, one-size-fits-all prosthetics would leave people in discomfort. Sure, their knee was replaced, but that didn’t mean walking was without pain, or getting up and down from a chair was without discomfort.
He said increasing sophistication, spearheaded by companies like Stryker, made for better comfort post-surgery, but technology like this robot takes things a step further.
The 3D computer modeling ensures greater accuracy, the machine’s built-in defenses provide for safer procedures, and doctors can leave the operating room more confident that accuracy was upheld, he said.
After Stryker acquired this technology in 2013, Mako’s first total knee commercial use was three years later, with a widespread launch in 2017.
Today, Mako has helped perform more than 300,000 procedures in more than 600 hospitals, and 1,000 surgeons have been trained to use it.
Dr. Seth Jerabek, an orthopedic surgeon at Hospital for Special Surgery (HSS) in New York City, first worked with Mako in 2010 when he was a medical fellow. One of his mentors was an early adopter of the tech, and Jerabek was brought on board.
“People are kind of like snowflakes, from far away, they look the same, but if you look close, you see how unique people are, you really start to appreciate the subtleties and difference in patient anatomy,” Jerabek told Healthline. “The crux of this technology is that it is so precise, I can get a CT scan plan in three dimensions, every plan is a little different.”
Jerabek found that the robotic technology is able to ensure those little subtleties of the human body are taken into account. He views Mako not as a robot surgeon, but as the ultimate assistant.
He believes the results speak for themselves and encourages fellow surgeons to consider lobbying their hospital to get Mako robotic assistants of their own.
“Get your hands on it and see how it works for you in the OR [operating room],” he advised those who may be interested in using Mako. “It’s amazing to see the number of fellows who end up adopting the robotics [once they’ve tried it].”
Cohen said the Mako robot’s future involves tweaks in software, as the robot itself has been perfected, but the tools it has to work with on its own can always be refined.
He said right now, Stryker has engineers developing software for shoulder surgeries, for instance.
Jerabek said he’s been struck by how many people request robotic-assisted surgeries. Now that this technology proliferates through the public consciousness, he said he sees a future where more and more people demand the kind of accuracy that robotics can provide for their hip and knee replacement surgeries.
“It’s interesting that patients are starting to understand what it is, they’re actually looking for it, specifically coming to me for this,” he added. “I’m looking forward to see where this technology will be going 5, 10 years from now.”