By Omkar Khandekar
Precision is the key to surgery and to achieve that, doctors can now perform a virtual operation before putting a patient under the knife.
A hospital in the city implemented a new technology–patient-specific instrumentation (PSI) knee replacement surgery–in which, the doctors digitally planned a surgery to the last detail beforehand, and later, executed the steps. Through the virtual process, they not only knew the exact dimensions of the bone of the patient but were also aware of the problems they might face when they cut open the patient’s knee. Before Mumbai, the method was used only once in Delhi.
Neena Agarwal (61) from south Mumbai had been suffering from a knee problem for the past 15 years and the fact that she weighed 114 kg, complicated her case even further. The doctors at Fortis Hospital in Mulund decided that if anyone needed a surgery with precision, it was her. The technology involved taking MRI scans for an accurate threedimensional measurement of Agarwal’s knee. "In the conventional method, the planning takes place at the time of the operation. The PSI knee replacement allows a doctor to first operate virtually, making surgical cuts and spatial placement on an image before taking the patient to the operation theatre," said senior orthopaedic consultant Dr Kaushal Malhan.
"In this process, there is less blood loss than the conventional method and patients recover faster." He said the technique could even be extended to other complex operations such as cranioplasty and neurological surgeries.
Agarwal, who underwent the surgery last Thursday, started to walk within a week. "I could not bend my leg more than 70-80 degrees. But after the surgery on last Thursday, I can now walk almost without support," she said.
The only drawback to this procedure is the extra cost. While a conventional normal knee replacement costs around Rs1.5 lakh, for the PSI, a patient has to pay an additional Rs 40,000
Matter of Image
- Before a surgery operation, a doctor takes the MRI for a precise, 3D measurement of the body part operated upon
- Using the image and specialized computer software, the doctor plans the surgery to the last detail
- During the actual operation, the surgeon repeats the steps that he performed on the digital image