Orthopaedic & Spinal Surgery, the Future Paradigm – are we there yet?

18th Feb 2022

According to the World Economic Forum, we have now entered the Fourth Industrial Age. The term relates to the revolutionary capabilities becoming available due to the merging of ‘cyber-physical systems’ (people and machines), and its impact echoes throughout healthcare.

Blackrock Clinic’s faculty of ‘Orthopaedic & Spinal Surgery’ is at the fore. As one of the most progressively equipped units in the country, medical technologies such as Brainlab Spinal Navigation (3D simulation), the Mako Robot (AI), advanced imaging modalities, and participation in the Irish National Orthopaedic Register (INOR), are supporting our surgeons to improve patient outcomes, and pioneer new treatments within their fields.

At Blackrock Clinic’s Orthopaedic & Spinal Department, people, spaces and things have great connectivity.

Our Things

The Mako orthopaedic robotic system (installed 2021) is the latest addition to Blackrock Clinic’s surgical robotics repertoire. It is an impressive use of AI to complement our joint arthroscopy (replacement) expertise. Currently programmed for hip and knee, the software will soon be updated to include the shoulder.

The Mako system tailors the surgical experience to each patient, generating a high definition 3D personalised surgical template. This gives the surgeon a unique patient anatomy, allowing for customised surgical assessment and planning. Benefits to the patient include: improved implant positioning; reduced postoperative pain and need for analgesics; shorter hospital stay; lower number of post-operative physiotherapy sessions.

All of this ultimately gives the patient greatly improved post-operative quality of life.

Blackrock Clinic is proud to bring together the largest number of orthopaedic surgeons in Ireland trained to use the Mako robot.

The Brainlab Spinal Navigation system (installed 2018) is a cyber / surgeon partnering which again amplifies the physician’s own skill and experience. The system and surgeon work in tandem, providing unique patient insights through image guidance, not unlike sat-nav.

The insights are accessed via the operating theatre’s imaging systems. The surgeon benefits from improved visibility and accuracy via real time 2D, 3D, MRI or CT images and datasets.

Fewer verification scans are required, with the considerable advantage of reduced radiation exposure to both the surgical team and patient. This furthers our objective to lower radiation dosage hospital wide.

Spinal navigation software is used both before and during spinal surgery, in planning, or navigating the positioning of surgical instrumentations (pins, screws etc.). Some instances of its use are in: the planning of cervical, thoracic and lumber spinal surgeries; complex deformity surgery; tumour treatment.

Interesting facts about Blackrock Clinic’s Orthopaedic and Spinal Department

Blackrock Clinic is the second largest Irish scoliosis centre after Crumlin Hospital.

We boast an impressive line-up of orthopaedic spinal specialists, offering complex yet minimally invasive procedures such as Minimal Access Spinal Surgery (MAST) and Direct Lateral Interbody Fusion (DLIF).

We never tire of firsts. In January 2016, Ireland’s first Percutaneous Endoscopic Discectomy was performed here. This is a ground-breaking procedure to relieve back-related leg pain. As this technique causes less muscle damage and patients experience much faster recovery times, it is a first choice for sportspeople.

Our Spaces

Blackrock Clinic has three new dedicated Orthopaedic Operating Theatres, fitted out to accommodate our roaming array of cyber-tech (robotic, diagnostic, and interventional equipment) which now travels with the surgical teams. The spaces are minimalist. Storage is ‘built-in’ to house IT integration and multimedia equipment. Powder coated stainless steel panels maximises infection control and give a seamless futuristic finish. Space is maximised and clutter reduced. There is a cool calm to the environments, where anything might be made possible, and often is.

Cyber space is inhabited by our state of the art radiology information system (RIS), cardio-vascular (CVIS) IT, and picture archiving system (PACS). This expansive solution to complex hospital reporting and imaging was installed in 2018, and interfaces in sync between our physical systems and stake holders: scientists; doctors; other medical facilities; patients.

Our People

Some of the best Surgical Consultants in the country work at Blackrock Clinic. This is because we support them in new surgical techniques and provide them with the cutting edge facilities they need to do so. They are joined by world class teams of allied health and nurse specialists. The faculty teams are trained internationally in niche skills such as robotic and laparoscopic surgical techniques. We partner with the RCSI in clinical education.

Our current Orthopaedic specialists cover an impressive surgical range, both complex and routine, including:  

• Hip and Knee arthroscopy, replacement and revisions,
• Shoulder surgeries,
• Sports injuries,
• Intradural neurosurgical work to degenerative spinal disorders,
• Tumours,
• Spinal deformities (paediatric and adult),
• Minimally invasive spinal surgery,
• Elbow, hand and foot surgeries.    

Electronic Data

A major asset of cyber-sophisticated systems is data capture. Analytics are a powerful tool, useful in our stringent clinical governance. In 2020 we networked our data by becoming the first private hospital in Ireland to participate in the INOR managed by Ireland’s National Office of Clinical Audit.  INOR is an electronic system which records and monitors all elective hip and knee joint replacement procedures performed in participating hospitals.  It tracks implant performance and patient outcomes, providing continuous feedback to patients, participating centres and surgeons, improving quality of care through shared learning. 

Are we there yet? We’re close.