Revolutionising local surgery
Written by Kerrie Alexander
The once sleepy town of Hervey Bay is growing exponentially and with that growth comes new and exciting medical technology that was previously not available to regional areas.
Hervey Bay folk are fortunate that husband and wife team Navi and Bec Bali were drawn to our part of the world. After deciding to leave the bleak and gloomy weather of England in pursuit of a better outdoor lifestyle, Navi moved to Hervey Bay from Brisbane about seven years ago so he could fulfil his regional duties with Queensland Health. After getting a job in Hervey Bay, he met Bec his now wonderful wife, they set up their own clinic and the rest was history!
Navi is a highly respected Orthopaedic Surgeon and Bec is a nurse and Practice Manager at The Bay Orthopaedic & Fracture Clinic, which they opened in Hervey Bay almost three years ago.
“I couldn’t believe that Hervey Bay was this beautiful, idyllic place,” Dr Bali said.
“We live close to the beach, the kids are safe and happy, and we have a very lucky lifestyle with great weather; it’s very much what we were looking for.”
The two brought with them a wealth of knowledge in the orthopaedic and fracture field, particularly Navi who is fully qualified to perform robotic-arm surgeries for patients who need a full hip replacement, or a full or part knee replacement.
Navi worked with St Stephens Hospital to bring the Mako robotic technology to Hervey Bay, allowing local surgeons to use this technology, so patients no longer needed to travel to metropolitan areas.
“Being able to offer this technology in a regional area is a great medical boost for the community,” Dr Bali said.
“We are very grateful that St Stephens worked hard with us to bring this medical innovation to the local area. They really are a wonderful team to work with.
“Previously you had to go to Brisbane to access this. I believe many years ago there was the perception that you had to go to the metropolitan areas to access optimal care, but with the group of orthopaedic surgeons we have locally we believe that isn’t true anymore.
Navi and Bec gave Alive owner Joy and I the thrill of dressing in scrubs and showing us behind the scenes where all the medical magic happens.
For this journo who knows nothing about medicine, listening to how the Mako technology works and how the surgery is performed absolutely amazed me.
Dr Bali said it’s currently one of the most commonly used orthopaedic robots that’s available and has a rich history behind it. Mako robotics recently celebrated a milestone of one million procedures globally, so it’s safe to say it’s been tried and tested.
Let’s bust one myth right now, though. The robot does not do all the work!
Robot-assisted surgery might sound like a plot right out of a science fiction novel. But the truth is, this technology has been around since the 1980s.
In a changing world where robots are replacing people, you might wonder if this is just another instance.
But rest assured, robotic surgery wouldn’t be possible without highly qualified human hands.
“I am definitely in the room doing the surgery,” Dr Bali said with a laugh.
Here’s how it works.
Robotic surgery allows doctors to perform joint replacement procedures with more precision than is possible with traditional manual procedures. (Ref 1, 2, 3)
Before surgery Dr Bali arranges a CT scan prior which is sent to the United States so they have a virtual 3-Dimensional model of the patients joint, as well as its relationship to other joints, before planning the hip or knee replacement.
During surgery, the first thing to do is match the patient’s real-life anatomy with the robots 3 dimensional model by referencing at least 30 points on the joint which need to measure within 1mm of the robots virtual 3D model. Once the dots match up the robots goes ‘green’ and is now live to plan and execute the surgery. Dr Bali looks at the preoperative plan and adjusts it sightly depending on the feedback from the robot on how tight or loose the ligaments are as well as the patient’s anatomy, and when the joint replacement has been virtually positioned the robot arm is brought in to do the cuts and execute the plan. The robot has patented haptic boundaries, which means that the saw or burr can only go within tightly constrained boundaries, so that only the essential bone is removed with the potential of less damage to the surrounding tissues. This has the aim of less postoperative pain and a quicker recovery when compared to manual techniques. (Ref 4, 5, 6)
With the advent of robotic surgery allowing more accurate placement and bone cuts, Mako robotic assistance is currently the most common way that partial knee replacements are performed in Australia.
Dr Bali said most of the discomfort and swelling resolves by 4-6 weeks in the majority of cases, but the final result won’t become apparent until around 4-6 months.
The recovery period, which of course is different for everyone, is a small price to pay for getting back on your feet, literally!
“We want to let the local community know we are all working hard to provide great care and make people aware this is available and how it works.
“Everyone who has been identified as an appropriate candidate for joint replacement surgery can undergo their treatment robotically, and we haven’t come across someone that is not suitable for robotic surgery as yet.
Dr Bali simply wants to let residents know that this potentially life-changing technology is available in Hervey Bay.
They have so much more information to share with patients with pain in their joints, so if you would like to have a discussion on the options available, give the team at The Bay Orthopaedic & Fracture Clinic a call on 4128 0736 or visit the http://www.thebayorthoandfracture.com.au.
- Anthony I, Bell SW, Blyth M, Jones B et al. Improved accuracy of component positioning with robotic-assisted unicompartmental knee arthroplasty. J Bone Joint Surg Am. 2016;98-A(8):627-35.
- Mako Total Hip: Domb, B.G., El Bitar, Y.F., Sadik, A.Y., Stake, C.E. and Botser, I.B., 2014. Comparison of robotic-assisted and conventional acetabular cup placement in THA: a matched-pair controlled study. Clinical Orthopaedics and Related Research®, 472(1), pp.329-336
- Mako Partial Knee: Hampp, E.L., Chughtai, M., Scholl, L.Y., Sodhi, N., Bhowmik-Stoker, M., Jacofsky, D.J. and Mont, M.A., 2019. Robotic-arm assisted total knee arthroplasty demonstrated greater accuracy and precision to plan compared with manual techniques. The journal of knee surgery, 32(03), pp.239-250.
- Herregodts S, Verhaeghe M, et al. Soft tissue penetration of the oscillating saw during tibial resection in total knee arthroplasty. The Bone & Joint Journal. 2020; Vol 102-B No.10.
- Kayani, B., Tahmassebi, J., Ayuob, A., Konan, S., Oussedik, S. and Haddad, F.S., 2021. A prospective randomized controlled trial comparing the systemic inflammatory response in conventional jig-based total knee arthroplasty versus robotic-arm assisted total knee arthroplasty. Bone Joint J,2021 Jan: 103(1): 113-122.
- Kayani B, Konan S, Tahmassebi J, Pietrzak JRT, Haddad FS. Robotic-arm assisted total knee arthroplasty is associated with improved early functional recovery and reduced time to hospital discharge compared with conventional jig-based total knee arthroplasty: a prospective cohort study. The Bone and Joint Journal. 2018;100-B:930-7.