Delegates at the British Society for Computer Aided Orthopaedic Surgery Conference will hear that results from a pilot study saw graduates 95 per cent more confident using this robotic technique than when using conventional surgical methods in training.
Professor Justin Cobb, Head of the Biosurgery and Surgical Technology Group at Imperial College London, conducted the trial on 32 undergraduate medical students at Imperial College London from December 2006 to December 2007. The pilot study tested whether planning before an operation, combined with the latest robotic navigation equipment could increase the success rates of students practising hip resurfacing arthroplasty procedures – a method for correcting painful hip bone deformities by coating the femoral head with a cast of chrome alloy.
Up to 5,000 hip resurfacing operations happen each year. These operations are technically demanding and require precision and accuracy. Surgeons rely on years of experience and on different cameras, lasers and hand held tools to help them navigate during an operation.
Inexperienced surgeons often face a steep learning curve to gain the experience necessary to carry out hip resurfacing operations. Until now, this has only been gained through repeatedly performing the operations. This can cause problems because if hip bones are repaired incorrectly wear and tear occurs, requiring patients to undergo further painful and expensive corrective operations. Imperial researchers believe their method will address the issue at the undergraduate level.
Third year medical undergraduates were asked to trial a state-of-the-art robot called the Navigation Wayfinder - a new navigation tool never before used in the UK.
The Wayfinder is similar to a GPS tracking system. It helps the user to navigate during surgery by plotting correct surgical incisions. It also calculates the correct angles for inserting chrome alloy parts needed to repair hip bones.
It has twin digital arms protruding from a console. One senses the movement of surgical tools as they slice through a patient's hip area. The other takes detailed images of the bones. This information is fed into software which generates a virtual model of a patient's hip as it is being operated on. Similar to a 3D roadmap, it allows the user to plot the progress of an operation as they are performing it – a vital technique for ensuring that it is being carried out correctly.
Professor Cobb saw the benefits of incorporating the Wayfinder into undergraduate training and developed a three step training programme.
Students used model replicas of deformed hip bones for the trial, scanned by the Wayfinder's digital arm. This information was used to create a 3D virtual model of the bone area.
The Wayfinder's computer programme developed an operation plan setting out the actions required for undergraduates to correct the hip deformity.
Students were asked to carry out a virtual operation on the 3D model of the hip. Using the tool tracking arm, they practised techniques for fastening chrome alloy on virtual deformed hip bones. This built up their confidence, technique and skill.