Patients at Universiti Kebangsaan Malaysia Medical Centre benefit from cutting-edge technology writes Meera Murugesan

IN the past, spine surgery was a long and anxious process for patients. They were left immobile and face down in the Intensive Care Unit for as long as five days, before even attempting to walk.

But today, with Minimally Invasive Surgery, (MIS), patients can be up and walking in as little as eight hours after surgery. They can even be discharged after one day and be back at work within the same week.

Universiti Kebangsaan Malaysia Medical Centre (UKMMC) is leading the way globally in this aspect as the first hospital in the world to use the cutting edge Zeiss Kinevo 900 robotic surgical microscope for spine surgery. This device allows surgeons to operate with greater speed and precision, thus cutting down surgical time by half.

At a public healthcare facility like UKMMC, the ability to shorten the duration of surgery and the length of hospitalisation means more people can receive treatment.

With the latest method and equipment, patients coming in for elective spine surgery now only wait for three months on average, compared to 6-9 months when using traditional open surgery methods.

The Kinevo 900 surgical microscope from Zeiss.

Datuk Dr Mohd Hisam Muhamad Ariffin, a spine surgeon at UKMMC, says spine surgery in the past was greatly inconvenient for patients.

Much of their back had to be cut open, and they had to spend days immobile and face down before attempting to walk, with hospital stays of up to a week overall.

“The majority of our spine surgery patients are elderly and have slower healing capability, so MIS helps by vastly reducing the size of the surgical wound. The incision is typically just an inch long for each part of the spine that needs surgery. With smaller cuts, we can make the surgery safer.”

The overall risk from spine surgery is 3 per cent globally, but with MIS, it can be reduced to only 0.2 per cent. Meanwhile for diabetics, the risk can be lowered from 20-25 per cent to less than 1 per cent with the MIS method.

Dr Mohd Hisam explains that while MIS has been used for spine surgery at UKMMC since 2009 and an older surgical microscope model has been used since 2012, the installation of the latest model with robotic technology and cutting-edge visualisation in March 2018 has greatly benefited surgeons and patients alike.

“In a government healthcare facility like UKMMC, there is a common perception that equipment is not the best and there are long waiting lists. We want to dispel this myth. The world’s latest medical technology and techniques are available in Malaysia’s public healthcare facilities and it makes a big difference in cutting down on waiting time.”

A decade ago, when open surgery was used, typical waiting times for elective spine surgery could be as long as 6 to 9 months. Today, with MIS and a surgical microscope with robotic technology, the waiting time has been reduced to three months on average.

“We can perform about three surgeries every day, and each surgery is at least 50 per cent faster, coupled with a much faster recovery period thanks to MIS and we can free up hospital beds for other patients,” he adds.

Dr Mohd Hisam and his team at UKMMC performing minimally invasive spine surgery with the help of the Kinevo 900 surgical microscope.

Jaswant Singh Khosa, 80, who is currently the oldest patient to have been operated on using the new equipment, only spent three days at the hospital compared to the typical 10 days for elderly patients when open surgery was used in the past.

“I feel much stronger now. I can move my legs much more easily and stand up on my own,” says Jaswant.

Dr Mohd Hisam commends Jaswant and his family on their discipline in keeping to home physiotherapy methods that were taught to them after the surgery.

Formal physiotherapy sessions were also done at UKMMC beginning 10 days after Jaswant’s surgery.

“I always tell my patients that what I can do for them is only 60 per cent, the remaining 40 per cent is the hard work they need to commit to for physiotherapy. The patient’s commitment to their own recovery is as important as the surgeon’s ability,” he says.

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