Issue link: https://viewer.e-digitaledition.com/i/982001
Aditya M. Derasari, MD A DIT YA M. DER A SA RI, MD, orthopedic surgeon, Director of Total Joint Arthroplasty Service at NewYork-Presbyterian Queens and Assistant Professor of Clinical Orthopaedic Surgery at Weill Cornell Medicine, is a board-certified orthopedic surgeon who has been with the hospital for almost four years. "I enjoy working at a large hospital where I'm able to teach residents," Dr. Derasari says. "There's a nice mix of academic opportunities, and our orthopedic department represents vari- ous subspecialties." Dr. Derasari received his medical degree from the University of South Florida College of Medicine before spending time at Jackson Memorial Hospital for his residency in orthopedic surgery. He went on to complete a fellowship in adult reconstructive surgery at Houston Methodist. He appreciates being able to work in orthopedic surgery — a well-defined field that provides proven solutions to patients. "I typically complete between two and four operations with the robotic arm in a given week," Dr. Derasari says. " The guide on the robot keeps us from cutting any healthy bone. Once the surgical site is locked in, there's no variability. When the information is put into the machine appropriately, we can't miss." ADITYA M.•DERASARI, MD, ORTHOPEDIC SURGEON, DIRECTOR OF TOTAL JOINT ARTHROPLASTY SERVICE AT NEWYORK•PRESBYTERIAN QUEENS AND ASSISTANT PROFESSOR OF CLINICAL ORTHOPAEDIC SURGERY AT WEILL CORNELL MEDICINE sizes on ha nd a nd f ind the correct one during the procedure. Now, since we k now t he exact dimensions a head of t i me , we c a n pr epa r e t he pa t ient 's acetabular bed to accept the cup implant at the sa me time." SURGICAL MAPPING T he rob ot sof t w a re's 3 -D pl a n n i n g model not only provides surgeons a view of the patient 's anatomy before surger y, but it is a lso used during procedures to improve accuracy a nd g uide surgeons a s t h e y p e r f o r m n e c e s s a r y c u t s a nd rea ms. Before surgeons perform a ny cuts to bone, t he pat ient 's ex posed bone i s ma rked at severa l points with a probe. These ma rks a re used to ensure that t he preoperative 3-D model matches the patient 's a natomy as the surger y is performed. The points are overlaid with the 3-D model, a llowing the robotic arm to position itself appropriately so the surgeon can safely perform the replace- ment procedure. W hi le the robotic a rm a nd cut ting dev ice a re control led by t he surgeon through a ha nd le a nd trigger mecha- nism, the robotic arm has an additiona l sa feg ua rd to ensure surgeons do not unnecessa ri ly remove bone or tissue that should rema in in place. Based on the 3-D model and the marked bone, the robot limits the surgica l area a surgeon can work on. Should the surgeon attempt to move the robot arm past these pre- defined boundaries, the arm will stop a nd keep t he su rgeon f rom mov i n g outside of the operating area. Surgeons can, however, ma ke adjust- ments a nd input new mea surements into the robot 's sof t wa re prog ra m in ca ses where t here a re discrepa ncies between the 3-D model a nd the actua l ma rked bone a rea . D u r i n g more t r a d it ion a l m a nu a l surgery, jigs are pinned to the bone based on the position of anatomical landmarks and a llow for the proper placement of cuts and bone remova l. This process is laborious a nd ca n ta ke a substa ntia l amount of time. "In the past, if we needed to take more bone or rotate the jig a f ter our initia l cuts, we would have to pin the jig again, recheck its placement, and ma ke sure every thing still lined up," Dr. Derasari says. "Now, if an implant is too tight, we ca n go into the prog ra m a nd remove 1 6❱❱❱❱❱ S P E C I A L F E A T U R E 1 6