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Robodoc' performs first successful surgery on human

By TED APPEL

SACRAMENTO, Calif. -- In a worldwide medical first, a 7-foot robot dubbed 'Robodoc' with nerves of steel and a hand more steady than a human surgeon has helped doctors replace a man's hip with an artificial joint.

Dr. William Bargar said the groundbreaking operation at Sutter General Hospital could pave the way for other types of robot-assisted surgery in the future.

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'Maybe we can help do current operations better,' Bargar told a news conference Monday. 'There may be new operations never attempted because you didn't have this kind of tool.'

The robot is a single-arm machine similar to those used in factories to assemble electronic components. Named Robodoc by its creators, the robot used a small rotary cutting tool to carve out a cavity in the top of the man's thigh bone to precisely fit the metal hip implant. Bargar and a team of doctors then manually placed the prosthetic implant into the cavity and completed the procedure.

Hospital officials said the patient, a 64-year-old man suffering from osteoarthritis, was resting comfortably and in stable condition following the operation. His name was not disclosed.

The surgery, performed Saturday, was the first of 10 test operations approved by the federal Food and Drug Administration to determine whether Robodoc is safe and effective.

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Hip implants are used to replace joints that have been damaged by arthritis, trauma, tumors and other causes. Doctors perform hip replacement surgeries on 250,000 Americans and 255,000 Europeans annually, hospital spokeswoman Beatrix Wilson said.

Traditionally, doctors must use a mallet and chisel-like rod to hollow out an imperfectly sized cavity in the bone to accept the hip implant. With Robodoc, doctors can program the robot to carve the exact dimensions of the implant, producing a perfect fit that will improve the stability of the prothesis, reduce pain after surgery and encourage rapid bone growth that attaches the limb to the porous surfaces of the implant.

Ten days before the hip surgery, three small calibration pins were implanted into the patient's femur to serve as reference points for the robot. A computer imaging scan was then performed on the bone, and three-dimensional X-ray images were fed into Robodoc's computer.

A computer program allowed Bargar to determine the best size and location of the implant before the surgery took place. The operation took nearly six hours, about double the amount of time for a traditional hip replacement surgery.

The robot was developed by Bargar and veterinarian Howard 'Hap' Paul over the last six years at a cost approaching $10 million. Their company, Integrated Surgical Systems Inc. of Sacramento, created Robodoc with help from International Business Machines Corp. and the University of California, Davis.

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Robodoc was tested 26 times on dogs before the FDA approved the feasibility study on humans, Paul said. All the dogs survived the operation and only one has died, from unrelated causes, he said.

Bargar said it could be 'months or years' before the robot is approved for use in other hospitals.

'We are right at the beginning of the study,' he said. 'We can't make any claims that this can do anything at this point.'

Robots have been used in the past to show doctors where to make an incision, but Paul said Saturday's operation was the first time a robot has performed the actual procedure.

In the future, Robodoc could be used for ligament and knee replacement surgeries, Bargar said. He speculated that robots may eventually be used for complex eye surgeries and excising tumors.

However, Bargar said he did not think robots would ever replace surgeons in the operating room.

'This can't replace any part of what the surgeon does,' he said. 'To me, it's a tool -- it's a tool to do one part of the operation and no more than that.'

The use of robots will not lower the cost of hip replacement surgery, but may allow patients to recuperate and leave the hospital more quickly, hospital administrator Lawrence Maas said.

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