Mako
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Orthopaedic robotic system
The Mako system is a high-tech robotic system for prosthetic orthopaedic surgery. It consists of a robotic arm, vision module and guidance module. The robotic arm is used to reproduce on the patient what the surgeon has planned with pinpoint precision using the software, thereby eliminating manual errors.
It assists the surgeon by establishing guidance spatial limits and showing relevant data on anatomical structures during orthopaedic procedures.
Mako is designed to assist in knee and hip replacement procedures requiring stereotactic surgery and where reference to rigid anatomical bone structures can be identified using a CT-based model of the anatomy. These procedures include: unicondylar and/or patellofemoral knee replacement (partial knee arthroplasty – PKA), total knee replacement (total knee arthroplasty – TKA), and total hip arthroplasty (THA).
The Mako robotic system has three elements.
A robotic arm
Six computer-assisted joints on a trolley that contains all the electronics required to operate the robot. The sixth joint is closest to the patient, to which the bone preparation systems are screwed. This means that the Mako system always has precise and safe control of the location of the bone preparation instrument. It is this feature that enables the robotic arm to execute the planned operation with pinpoint precision.
A vision module with monitor
This allows the surgeon to see all the necessary information to correctly position the prosthesis. Equipped with precise infrared cameras, the Mako system is always aware of the position of all the elements of the system, which are constantly monitored.
A guidance module
This is controlled by a certified biomedical engineer who is present throughout the procedure to ensure it is performed correctly and to maximise the performance of the robotic system.
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N.B.: Pursuant to and for the purposes of Art. 76 of Italian Presidential Decree (DPR) 445/2000, aware of the liability and the civil and criminal repercussions for false declarations and/or for the preparation or use of false documents, as well as in the event of the production of documents containing information that no longer corresponds to the truth, I confirm that I am a HEALTHCARE PROFESSIONAL.
OPERATIONS
The patient has a CT scan of the joint to be operated on. A 3D model of the joint is then created based on the CT images. This is uploaded to the Mako system, allowing the surgeon, days before the operation, to study the patient’s anatomical characteristics and select the most appropriate prosthesis.
On the day of the surgery, the Mako system acquires further information on the functioning of the joint in order to have a complete anatomical-functional picture.
In this phase, the surgeon can adjust the positioning of the prosthetic components by millimetres in order to ensure the best patient outcome.
The robotic arm is used in the last and most important phase: it moves within a virtual cage that constrains the positioning of the implant (AccuStop patented technology) and prevents damage to the viable tissue. The robotic arm guarantees that the procedure that was planned with the Mako system software is executed with pinpoint precision. This method negates the need for cutting guides and perforation of the intramedullary canal, which are key steps in manual surgery.
As well as reducing the margin of error, tissue retraction during the procedure is minimised (minimally-invasive surgery) and there is less bleeding. The postoperative benefits are clear, with patients experiencing less pain compared to after a guided or manual procedure.
Once the bone has been prepared and the final prosthetic components placed, the Mako system records the values obtained, reassuring both patient and surgeon of the success of the operation.
Clinical benefits
- Safe, precise and repeatable cutting
- Preoperative planning and conduct of the operation based on a patient-specific CT-based 3D model
- Robotic arm that actively assists the surgeon in cutting and milling by creating safe stereotaxic boundaries T
- The Mako system boasts three available applications: PKA (unicompartmental [partial] knee arthroplasty), TKA (total knee arthroplasty) and THA (total hip arthroplasty)
Benefits for the patient
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Less painful procedure, with quicker recovery and reduced reliance on painkillers
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The prosthesis feels more natural
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Rapid resumption of normal daily activities with reduced social impact, both in terms of illness as well as family care for the patient
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Minimally invasive, which reduces, and in some cases negates, the need for blood during the procedure
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Greater preservation of bone tissue, which may be useful if further surgery is required years later
Areas of application
The Mako robotic platform has been designed to assist in the first replacement of all large joints and is currently used for knee and hip arthroplasty.
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Medial unicompartmental knee arthroplasty
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Lateral unicompartmental knee arthroplasty
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Total knee arthroplasty
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Medial plus patellofemoral bicompartmental knee replacement (with possible patella replacement)
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Isolated patellofemoral arthroplasty (with possible patella replacement)
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Total hip arthroplasty using all muscular approaches: Posterolateral or direct anterior or DSA (direct superior approach)
In the future, it will be possible to perform prosthetic surgery on joints such as the shoulder and spine.
07/08/2024
about care, who is speaking today? Dott. Caldora
Negli ultimi dieci anni, il sistema robotico Mako ha rivoluzionato la chirurgia ortopedica. Ascoltiamo il Dott. Patrizio Caldora, chirurgo specialista in Chirurgia Articolare e Robotica, nel racconto di un caso significativo e della sua visione sul futuro delle cure min...
16/02/2022
A Torino il sistema Mako, piattaforma robotica per la chirurgia protesica in ortopedia
All’Ospedale Koelliker di Torino è da poco arrivato il sistema Mako, una piattaforma robotica ad alta tecnologia per la chirurgia protesica in ortopedia.
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