Robotic Surgery Center

• Decreased Intraoperative Bleeding
• Reduced Pain
• Fast Recovery
• Reduced Risk of Complications 
• Improved Surgical Precision
• Shorter Hospital Stay
• Lower Infection Risk

• Robotic assisted Spinal Surgery
  • Lumbar Fusion Surgery
  • Spinal fixation Surgery
• Robotic assisted Total Knee Replacement
• Robotic assisted Total Hip Replacement
• Robotic assisted Urology Surgeries
  • Kidney Cancer
  • Prostate Cancer
  • Pyeloplasty
• Robotic assisted Otorhinolaryngology Surgeries
  • Oral and Pharyngeal Tumors
  • Salivary Gland Tumor Resection, Neck Lymph Node Resection, or Neck Cyst Removal
  • Tonsillectomy
• Robotic assisted General Surgeries
  • Bile Duct Cancer
  • Pancreatic Cancer 
  • Colorectal Cancer
  • Rectal Prolapse
  • Hernia Surgery
  • Stomach Cancer
  • Liver Cancer
  • Tumor Resection

ExcelsiusGPS® Robotic Navigation

Common Spine Problems

If there is a problem with the spine, such as intervertebral disc herniation, spinal stenosis, and intervertebral disc degeneration, it can affect various parts of the body. Relevant research shows that up to 80% of adults experience back pain, and spinal disease is one of the common reasons for seeking medical attention. For example, approximately 3 million Americans suffer from a herniated disc each year, while spinal stenosis affects approximately 200,000 Americans. These spinal problems often cause chronic pain, limited mobility, numbness, and weakness, making basic daily activities difficult and affecting the quality of life.

Application of the Robotic Arm Surgical System

Our hospital has introduced Hong Kong's first robotic arm surgical system, ExcelsiusGPS® that can be applied to the entire spine. Robotic arm navigation is mainly used for spinal fixation in spine surgery, such as inserting pedicle screws or fusion devices in the lumbar spine. The system can also be used for cervical spine surgery. Since the bones of the cervical spine are relatively 10 thinner and have lower tolerance for deviation, the assistance of robotic arms can effectively improve the accuracy of surgery.

In robotic arm surgery, doctors can also utilize a computer navigation system to assist in completing the surgery, less use of X-rays will result in lower radiation exposure for both patients and medical staff. Before the surgery, the doctor can pre-plan the positioning of the screws and the ideal screw sizes, which will improve the stability after implantation.  Compared with relying solely on X-rays and doctors’ clinical judgment in the past, preoperative planning and accuracy of robotic arm surgeries have been greatly improved.

Advantages of the Entire Spine Robotic Arm Surgical System

• Fast Recovery
• Less Pain
• Less Blood Loss
• Reduced Damage to Surrounding Soft Tissues and Muscles
• Shorter Surgical Duration
• Smaller Incision Size

ROSA® Robotic System 

Recent Situation

Bone and muscle loss is a common problem in the aging population, and it often leads to knee joint pains. Many patients with this problem have to replace their knee joints by undergoing knee replacement surgery. Knee replacement surgery is one of the procedures with the longest waiting times in public hospitals. As of June 30, 2024, there were a total of 33,951 cases waiting for this surgery, with an average waiting time of approximately 4 years. Through professional diagnosis by orthopedic surgeon, advanced techniques and materials can be used to replace the joint with an artificial one, relieving the patient's pain and restoring their daily functional ability.

Normal joint space
Healthy articular cartilage

Narrowed joint space
Worn articular cartilage

Knee Joint Degeneration

Once the knee develops a pathological condition, the joint space narrows, and the articular cartilage is worn down and damaged, leading to pain and even deformity. The common causes include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, and osteonecrosis etc.

If the joint disease becomes severe, and conservative treatment is ineffective, the orthopedist will select the most appropriate knee replacement based on the patient's knee joint condition. The affected bone is removed, and it is replaced with metal. The cartilage portion is substituted with high-molecular- weight polyethylene, eliminating the direct friction of the metal surfaces.

Advantages of Robotic-Assisted Total Knee Replacement

After the professional diagnosis and selection of the appropriate artificial joint for the patient, orthopedic surgeon will perform joint replacement surgery to implant the artificial joint to patient's body. The ROSA® Robotic System provides stable, precise, and highly reproducible cutting, which can help the orthopedic surgeon to perform the surgery more accurately. Moreover, robotic system allows adjustment and personalization of bone cut and artificial joint position, which effectively reduce soft tissue damage and promoting postoperative pain relief, thereby improving surgical outcomes.

• Decreases Postoperative Pain
• Helps in a Faster Return to Daily Life
• Reduces Complications/Blood Loss
• Shortens Hospital Stay

Our hospital has collaborated with Zimmer Biomet to establish the first 'ROSA Robotics Surgery Center of Excellence' in the Greater China region. This center will provide a training base for orthopedic surgeons in Greater China and the Asia-Pacific region, focusing on robotic-assisted joint replacement surgeries. It will facilitate relevant training and academic exchanges, contributing to the popularization and development of robotic joint surgeries.

Da Vinci Xi Robotic Surgical Systems

The fourth generation of the Da Vinci Xi Robotic Surgical System is an advanced minimally invasive surgical system, with over 12 million procedures performed worldwide using this technology. The Da Vinci Xi Surgical System is utilized across numerous medical disciplines, particularly in addressing cancers such as stomach cancer, liver cancer, and pancreatic cancer.

Prostate Cancer

Today, robotic prostatectomy is widely used, and in the United States, it has become more common than conventional open surgery. With the assistance of the Da Vinci Surgical System, doctors carefully remove the prostate gland and pelvic lymph nodes using high-definition 3D images while preserving important nerves and blood vessels. This precision enhances patient safety and post-surgery outcomes.

Colorectal Cancer

The robotic surgical system is capable of addressing complicated rectal cancer cases while minimizing side effects, such as impotence, by preserving the pelvic nerve plexus. This system also allows surgeons to operate deeper into the pelvis to effectively remove hard-to-reach tumors while preserving anal muscle function, thus exempting patients from the need for a permanent stoma.

Stomach Cancer

Since the gastric lymph nodes are in close proximity to the aorta, the surgery is generally performed through an open abdominal approach. However, surgeons can also utilize a robotic-assisted system to perform the procedure more efficiently and effectively in removing the potentially infected lymph nodes, while avoiding damage to the nearby major blood vessels.

Liver Cancer

The liver is densely vascularized and closely connected to the bile ducts. The robotic-assisted system can provide a three-dimensional, clear, and magnified real-time image, as well as the ability to filter out any tremor from the surgeon's hands, further improving the precision and safety of the surgical procedure.

Pancreatic Cancer

The robotic-assisted system allows the surgeon to clearly visualize the internal conditions, perform complex procedures within the cavity from different angles, and conveniently dissect tissues in difficult positions or angles, while avoiding damage to nearby major blood vessels. This results in a faster recovery for the patient.

The Robotic Surgery Center team is composed of multi-disciplinary healthcare professionals, to ensure patient safety, our surgeons undergo rigorous training and certification and obtain clinical privileges for robotic-assisted surgery before being authorized to operate the robotic systems.

Recovery of the Robotic -Assisted Spinal Fusion Surgery Patient - Mr. Oliver Kadhim

Mr. Oliver Kadhim, in his early 40s, had been suffering from right lower back and leg pain, numbness, and aching for the past two years. At times, he could barely walk for more than a minute, which significantly impacted his work. He had tried acupuncture therapy and epidural steroid injections, but without much success. Considering he had four young children to care for, he ultimately decided to undergo surgical treatment. After examination, the doctors diagnosed him with a herniated disc at the L5 level, which was compressing the L5 nerve. They recommended an L5/S1 fusion surgery.

In March 2024, Mr. Kadhim underwent robotic-assisted surgery. He was able to get up and walk just a few hours after the procedure and was discharged the next day. Within 3-4 weeks of the surgery, he had made substantial progress in his recovery and was able to resume his normal exercise routine. The robotic-assisted spinal fusion surgery has allowed him to regain his mobility and quality of life, enabling him to better care for his family. 

Recovery of the Robotic -Assisted Knee Replacement Surgery Patient - Ms. Lam

Ms. Lam, a woman in her early 60s, had been suffering from severe left knee pain and swelling for around 7 years. While traveling abroad, she returned to Hong Kong and consulted multiple orthopedic specialists, who diagnosed her with a torn meniscus after an MRI scan. Though doctors recommended surgery, Ms. Lam was hesitant and opted for anti-inflammatory and pain medications instead. However, the following summer, her condition worsened, and during a trip to the mountainous city of Chongqing, her knee pain became unbearable, leaving her unable to fully extend her leg. Deciding to address the issue, Ms. Lam underwent a robotic-assisted total knee replacement surgery, which took approximately 1.5 hours. Just 2 hours after the surgery, she was able to walk with the help of a walker, without any pain. By the third day, Ms. Lam could walk and climb stairs independently, and the entire hospitalization and recovery process took only 5 days. Pleasantly surprised by her rapid recovery, Ms. Lam was able to resume her traveling and exercise habits, thanks to the robotic-assisted approach and her diligent rehabilitation.

1. What is robotic surgery?
   
   Robotic surgery is a method of surgery performed with the assistance of a robotic system. It combines the expertise of a surgeon with the precision and stability of a robotic system, which comprises multiple robotic arms and surgical instruments. Surgeons perform robotic surgery by operating the robotic surgery system.
2. What robotic surgical instruments does the Robotic Surgery Center at HKAH?
   
   - ExcelsiusGPS® Robotic Navigation
   - ROSA ® Robotic System
   - Da Vinci Xi Robotic Surgical Systems
3. What kind of surgery can adopt robotic surgery?
   
   Robotic surgery is used in many surgical fields. At Hong Kong Adventist Hospital’s Robotic Surgery Center, for example, robotic surgery may be used in urology, neurosurgery, orthopedics, otolaryngology, general surgery, and other areas.
4. Who should receive robotic surgery?
   
   Robotic surgery may be used across various specialties, and is considered an effective surgical method for certain cases. Whether a patient is a good candidate for robotic surgery depends on the doctor’s assessment based on the patient's specific condition and needs. Patients should discuss the benefits and risks of robotic surgery with their medical team to make an informed decision.
5. Who should not receive robotic surgery?
   
   While robotic surgery is generally safe and effective, some patients may not be suitable candidates for this type of surgery. Patients who are excessively overweight, for example, may not benefit from robotic surgery as the system needs to be able to position and operate on the patient with precision within the confines of the surgical area, and the patient’s body size may affect the movement of the robotic arms. Patients should discuss with their medical team to determine the suitable surgical approach.
6. What are the advantages of robotic surgery over traditional surgery?
   
   - Minimally invasive surgery: robotic surgery is performed through smaller incisions, making it less invasive compared to traditional surgery. Surgical trauma, pain, and risk of bleeding are reduced, while recovery time is shortened.
   - Enhanced precision: robotic systems are highly flexible and precise, allowing for accurate movements and increased control. Surgeons are able to make more accurate assessments, thereby improving the success rate of surgeries.
   - 3D visualization system: robotic surgery systems provide high-definition 3D visualization, offering surgeons a clearer view of the surgical area and allowing them to perform operations with greater precision and accuracy.
   - Improved stability: robotic systems offer stability and tremor compensation that counteract the surgeon’s minor hand tremors, facilitating more stable and smooth operations and reducing surgical risks.
   - Remote operation: robotic surgery may be performed remotely with surgeons controlling the system while seated at a console. This reduces the physical strain a surgeon may experience from having to maintain a fixed posture and position for extended periods of time.
   - Enhanced safety and reduced trauma to soft tissues and other organs
   - Reduced postoperative pain, contributing to faster recovery
7. Any risk from robotic surgery?
   
   Each surgery is unique, and the risks and complications depend on the patient's condition and the complexity of the surgery. The medical team assesses each patient's risks and provides appropriate recommendations and preventive measures. Patients should discuss the risks and benefits of the surgery with their doctor and consider their options carefully before making a decision.
8. Would it be more expensive for using robotic surgery than traditional surgery?
   
   The cost of the surgery depends on the patient's condition and the doctor's recommendation. Robotic surgery may be more expensive than traditional surgery, but it significantly improves surgical flexibility and allows for more precise treatment of areas that may be difficult to reach with traditional surgery. This often leads to shorter hospital stays and faster recovery, and therefore potentially reduces the overall medical cost. In light of this, the surgical cost of robotic surgery cannot be directly compared to that of traditional surgery.
9. Any qualification or training for doctors who in charge of robotic surgery?
   
   To ensure the safety of robotic surgery, doctors and medical teams need to understand the operation and functions of the robotic surgery systems. They must undergo specific professional training and meet the necessary qualifications before they are allowed to perform robotic surgery at the hospital.