The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Alexa Gagosz at email@example.com.
It’s been more than 10 years since South County Hospital pioneered the use of surgical robotic technology in Rhode Island’s operating rooms by being the first to use Mako SmartRobotics, by Stryker, for hip and knee replacements.
Dr. Robert Marchand, the orthopedic surgeon who led the way with this technology, can typically be found in one of the hospital’s operating rooms, where he not only makes it possible for his patients to regain mobility, but live-streams his techniques to other surgeons in live training sessions.
Prior to the pandemic, he was conducting about two live procedures each month. Since the pandemic began, he said he’s got patients’ hips and knees under the knife and on camera at least once a day.
Q: How do you sell this method to a patient?
Marchand: Precision is the key. Orthopedic surgeons would always look at X-rays. But that’s always after the fact. They would say, “Oh that looks pretty good,” or “I could have done better.” What patient would want to hear, “That surgery could have been better?” Using this technology is more precise than what anyone could do manually. And precision transfers to better outcomes.
Q: How is this method better, other than being more precise?
Marchand: In the old days, I would have to make the incisions a little bigger. I would have to put more retractors in to pull tissues apart. Those incisions, without this technology, are about one and a half times larger than the incisions I make when using this technology. The incisions with this method are smaller, and the tissue damage is less. That’s going to be a better outcome for the patient, and they’re going to recover a little quicker.
Q: Why don’t more orthopedic surgeons in Rhode Island use this technology?
Marchand: When I first started using this technology, I invited other surgeons from other health care systems down to observe. They wanted to learn it, but then they would go back to their systems and they wouldn’t have access.
I can’t answer for other institutions, but I can tell you that from the economics early on, it was a big purchase. Now, there’s all kinds of financial ways to acquire a robot, such as a lease. It’s much easier to afford now.
Last year, I did about 1,200 joint replacements myself. The state does about 4,500 in the state. To have this type of technology, you have to have a surgeon who is an advocate for it. Some surgeons are egotistical and frankly don’t think that they need it.
Q: Where are the Mako machines now?
Back in 2010, when all of this started, there was one Mako machine in Buffalo, three MAKO machines here in South County, and then one in New York in special surgery. Move forward 10 years, there are 1,000 Mako machines in the world. There’s one in Fall River, Mass General Hospital in Boston has one, and there are others in parts of New England [including Rhode Island].