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NHS First at RNOH for Single Stage Complex Spinal Procedure Using Surgical Robot

single stage surgical robot spinal procedure

Royal National Orthopaedic Hospital (RNOH) is the first centre in the NHS to successfully conduct a complex spinal surgery in one operation, rather than the usual two, by using a surgical robot. Such an innovative approach will help tackle waiting lists through decreased surgical time and reduced length of stay for patients.

A surgical team led by Consultant Spinal Surgeon Mr Michael Mokawem undertook the procedure known as an oblique lumbar interbody fusion (OLIF) using the Mazor X Stealth EditionTM (MXSE) surgical robot. OLIF is a minimally invasive procedure that involves the removal of damaged intervertebral disc and bone, and fusing of two adjacent spinal vertebrae. OLIF is usually completed in two stages due to the complex nature of the procedure: via anterior (the front) and posterior (the back) approaches. Using the Mazor, Mr Mokawem and his team undertook the procedure in a single stage, achieving a first of its kind in the NHS.

spinal surgery screen

Mr Michael Mokawem, Consultant Spinal Surgeon at the RNOH, said: “This is the first time that single position anterior and posterior robotic guided surgery has been done in the NHS. Robotic guided spinal surgery is an exciting technology that augments well-established surgical techniques with the ability to plan screw placement and execute the plan with accuracy, and precision. It allows us to safely operate from the front of the spine and the back of the spine simultaneously compared with the normal procedure of separating the two stages, either on the same day or more commonly on different days which takes longer. This procedure involves minimally invasive surgery and decreased tissue damage which leads to an enhanced recovery, and safely instruments the spine which decreases the risk of nerve damage, while also decreasing the radiation exposure to the theatre team. There is a large potential time saving through streamlining patient experience by decreasing total operating time, decreasing length of hospital stay and freeing up more surgical capacity which will improve waiting times for patients.”

The Mazor is the latest generation of robotic guidance platforms that assist surgeons with sophisticated real-time 3D imaging, advanced anatomy recognition and enhanced navigation that increases surgical precision. In 2019, RNOH was the first NHS hospital to offer Robotic Assisted Spinal Surgery (RASS) utilising field leading enabling technology that is transforming the operating theatre. RNOH will also become one of the first Reference Centres within Europe to train visiting surgical teams from around the globe in partnership with Medtronic Ltd, the manufacturer of the Mazor.

robotic surgery spinal procedure

Dr Lila Dinner, Chief Medical Officer of the RNOH, said: “RNOH has always been at the forefront of introducing innovative technology into the care and treatment plans for some of our most complex patients. This is a marvellous example of the values we all share to ensure the NHS continues to provide world-class care for all. Medical innovations such as this will help us tackle waiting lists, provide value for money to the NHS and improve patient outcomes. We are enormously proud of the innovative work of our spinal surgical unit.”

The Mazor can be used for both open and minimally invasive procedures and is seen as an extension of the surgeon’s skills; supporting the surgeon throughout the procedure. The technology is used in both paediatric and adult spinal surgical cases across a range of pathologies including spinal deformity, degenerative spinal disease, traumatic fracture fixation and in the management of spinal cancers. RASS helps surgeons to perform complex spinal procedures in a more minimally invasive way and reduce the overall time patients have to stay in hospital.

RNOH works to deliver the best patient and staff experience; our adoption of cutting-edge robotic technology creates an environment where our field-leading surgeons continue to pioneer surgical techniques and build great teams to deliver excellence in orthopaedic care.

The Spinal Surgical Unit at RNOH includes one of the largest Spinal Deformity Services in Europe. Referrals to this service come from throughout the UK and internationally, and the unit has a world-renowned reputation for its pioneering work. Specialist spinal surgeons treat a wide variety of patients with very complex problems. The RNOH is at the forefront of paediatric and adult spinal deformity surgery (scoliosis and kyphosis). Scoliosis is a curvature of the spine and the RNOH successfully treated HRH Princess Eugenie for this condition when she was 12 years old.

Source: Royal National Orthopaedic Hospital

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