When Glen Munroe woke up in the recovery room in January after getting a partial knee replacement, he caused a bit of a stir.
“Some of the nurses said, ‘Oh, you had robotic surgery!’ I almost felt like a celebrity for a little bit. People seemed impressed and I was too because I thought it went so well.”
“Instead of being a late adopter, now we’re actually leading the country in terms of technology adoption in robotics,” said Brittney MacKinnon, Director of Innovation at the Nova Scotia Health Innovation Hub. “We are not afraid to take risks.”
Innovator in Residence Dr. Michael Dunbar, a world-renowned orthopedic surgeon and researcher, was instrumental in bringing both Mako robots to the province. He saw the clinical need and made a successful case to the Health Innovation Hub to pursue the project and for funding from the QEII Health Sciences Centre Foundation.
The Health Innovation Hub brings together clinicians, industry and key health care decision makers to bring the latest technology to Nova Scotians. Through collaboration and partnerships “we are able to move things forward faster,” said MacKinnon. “It means Nova Scotians are getting access to cutting edge technology faster or first in the country, and our physicians like Drs. Michael Dunbar and Glen Richardson are able to develop surgical robotics in Canada.”
Using robotics, surgeons can make smaller incisions and perform more personalized and precise surgeries. In a joint replacement like Munroe’s, Dr. Richardson plans the operation with a Mako specialist using three dimensional images from a CT scan. “The advanced imaging allows us to consider nuances around implant sizing and alignment and that has led to more patient specific surgery, where I can really tailor the position of the implant to the patient’s anatomy,” said Dr. Richardson.
The ultimate goal is for the patient to have less pain, less time in hospital, a faster recovery and better outcomes in the long term. Research that evaluates robotics was built into the deal to bring the Mako robots to Nova Scotia. “Instead of just purchasing the piece of technology we were able to start collaborating with Stryker and build the research piece in from the beginning,” said MacKinnon.
Even after a successful joint replacement some patients have ongoing complications, lingering pain and limited mobility. Research that will help surgeons understand why one patient might have worse outcomes than another is being led in Halifax by Dr. Janie Wilson, Professor and Director of the School of Biomedical Engineering at Dalhousie University and affiliated researcher at Nova Scotia Health.
Dr. Wilson says extensive data gathered by the Mako robot “changes the game” on what researchers can do locally. “We now have the ability to create solutions and test solutions.”
With the MAKO system, the team of clinicians and researchers no longer has to rely on anecdotal information from the operating room to innovate. “Having very specific information of what happens on the surgical end allows us to use this information combined with our research happening outside of the operating room to improve and enhance surgical decision-making, which is something that we could not have done in the past,” said Dr. Wilson.
Ultimately, it will lead to more customized surgery. “It will trickle through to all surgeries happening in the province and elsewhere. The knowledge gained is not just going to benefit the patient receiving the robotic surgery, it can benefit all patients,” said Dr. Wilson.
Having a growing robotics program puts Nova Scotia in a strong position to attract top clinicians, researchers and trainees. “In Nova Scotia, medical students and residents from across Atlantic Canada are being exposed to the most up-to-date, innovative technology available on the market,” said Dr. Gail Tomblin Murphy, Nova Scotia Health’s Vice-President of Research, Innovation & Discovery and Chief Nurse Executive. “This enhances the province’s ability to be a magnet that attracts and retains bright minds and top talent.”
The payoff of bringing new technology like the Mako to Nova Scotia is the result of intentionally fostering complicated partnerships. “There are so many people involved and that’s where the Innovation Hub has been so critical”, said Dr. Richardson. “Once they make these connections and facilitate the use of technology, it makes it easier to do adopt the next innovation in healthcare. You get these processes in place so we’re able to move the needle in a way that is beneficial for both the provider and the patient.”
Glen Munroe is seeing the benefits. Before his operation even standing was painful. “It just opened my world back up because I was getting to the point where I couldn’t do anything,” said Munroe. And he will likely be a candidate for robotic surgery again. “I need to get the right one done and I’m all for it.”
