Issue link: https://viewer.e-digitaledition.com/i/982001
PRECISION PL ANNING Much of t he improved accuracy dur ing a r t hropla st y is a result of the pla nning process a nd sof twa re that is used in conjunction with the robotic a rm. The process at N YP Queens requires a CT scan of a patient 's hip or knee days or weeks before undergoing a r thropla st y. Specia l sof twa re creates a vir tua l 3-D model of the a ffected a rea based on the CT sca n. The 3-D model ta kes into account each patient 's unique a natomy. A preoperative pla n is then created, wh ich h ig h lig hts what a rea s of bone need to be removed and what areas need to be avoided to preserve hea lthy bone a nd liga ments. Surgeons ca n exa mine pla ns a nd ma ke adjustments before entering the operating room. "A representative from the compa ny that ma kes both the robot a nd sof twa re is on-site to help us develop preoperative pla ns a nd pa rse out the deta ils of the surger y," says Rober t Li, MD, attending or thopedic surgeon at N Y P Queens a nd Assista nt Professor of Clinica l Or thopaedic Surger y at Weill Cornell Medicine. " The pla ns help us determine the size of t he components we need a nd how to appropr iately place them. We know the depth, a ngles a nd positions for the bony cuts we w i l l ma ke before surger y beg ins. Persona l ly, this increases my conf idence because I know the patient 's exact a natomy beforeha nd." Prior to the advent of this technolog y, surgeons had no way of specif ying the exact size of impla nts a nd components they would require until surger y bega n a nd the bone was exposed. "For exa mple, with tota l hip replacements, we would only have a rough estimate of what size cup we needed before preparing the hip socket," Dr. Li says. " We would have multiple Robert Li, MD ROBERT LI, MD, attending orthopedic surgeon at NewYork-Presbyterian Queens and Assistant Professor of Clinical Orthopaedic Surgery at Weill Cornell Medicine, joined the hospital in September of last year. "I was raised in Flushing, Queens," Dr. Li says. "I'm thankful to be able to improve care in the neighborhood where I grew up and give back to the community." Dr. Li first gained an interest in orthopedics and surgery while working as a personal trainer during his undergraduate education at Boston University. While studying biomedical engineering, he realized he could combine his fascination with physics and engineering with his passion for helping people improve their health. Dr. Li graduated from New York Medical College and performed his orthopedic surgery residency at Albert Einstein College of Medicine and Yeshiva University, Montefiore Medical Center and Jacobi Medical Center before he completed an adult reconstruction fellowship program with New York University Hospital for Joint Diseases and the Insall Scott Kelly Institute. " The surgery itself is still the same when using the robot — whether it's total hip or knee replacement or partial knee replacement — but performed with more sophistication. We're making the same cuts with the same amount of exposure and the same implants, but the robot allows us to achieve our target angles every single time, especially in cases that may be more complex or patients who have deformities in their bone." ROBERT LI, MD, ATTENDING ORTHOPEDIC SURGEON AT NEWYORK•PRESBYTERIAN QUEENS AND ASSISTANT PROFESSOR OF CLINICAL ORTHOPEDIC SURGERY AT WEILL CORNELL MEDICINE Dr. Li led the first total knee replacement using the robot at NYP Queens. 1 5 M D N E W S . C O M /// M D N E W S L O N G I S L A N D ■ 2 018