Dr Wian van der Merwe, an orthopaedic surgeon practising at Netcare Pretoria East Hospital performs knee replacement surgery with the advanced Mako SmartRobotics system, assisted by registered nurse Madri van der Sandt and enrolled nurse Dineo Mokone.

A team of orthopaedic surgeons at the Netcare Pretoria East Hospital have started to perform hip and knee replacements with the use of a robotic surgical system after completing comprehensive training in Istanbul in Turkey with the SmartRobotics™ surgical system.

The Mako robotic system at Netcare Pretoria East Hospital is the first in Tshwane and one of only a handful of these advanced systems in South Africa. Dr Van der Merwe performed the first robotic assisted hip and knee surgeries at the hospital in late November 2021, and many more patients have since chosen to have this option for their surgery.

“By the end of June, a further two orthopaedic surgeons practising at our hospital will complete the final leg of their accreditation in the use of the robotic assisted system. This will result in a total of four experienced orthopaedic surgeons offering this option to people requiring knee and hip replacements at our facility,” Louw says.

Dr Van der Merwe explains that the Mako robotic system is designed to further improve surgical precision. The technology assists the surgeon in the planning of the procedure beforehand and provides additional checks in real-time at each stage during the operation.

“Based on a CT scan of the patient’s knee, the system’s sophisticated software develops a three-dimensional digital map of the knee, and calculates the optimal implant size, placement and alignment of the prosthetic knee joint to fit the patient’s specific anatomy. This data is then translated into a preoperative surgical plan,” Dr Van der Merwe says.

The system combines three key components – 3D CT scan-based planning, AccuStop technology and insightful data analytics – into one platform for more predictable and personalised orthopaedic procedures.

“This offers an extra level of precision, adding to the surgeon’s own technique and experience. On the day of the procedure, the digital 3D map of the knee is carefully aligned to the patient’s actual knee in theatre, and the surgical plan is validated,” Van der Merwe explains.

“The dimensions needed for the procedure are set, and at these boundaries cutting automatically stops, serving as an additional safeguard to preserve the surrounding soft tissues and healthy bone. The resections achieved are extremely accurate to the surgical plan, being within a fraction of a millimetre,” Dr Van der Merwe says.

As the surgeon guides the robotic arm system, it provides detailed visual, auditory, and tactile feedback. “The robotic system cannot do anything without the surgeon. Rather, it helps keep the surgeon within the optimal dimensions to match the patient’s individual anatomy through the defined surgical plan.”

Netcare Pretoria East Hospital is the fourth facility within the Netcare Group where robotic assisted knee and hip replacement surgery is available. The others are Netcare Linksfield, Netcare Pinehaven and Netcare Blaauwberg hospitals.