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Written by: dr. Schröder

Dr. Schröder no longer works at Bergman Clinics

This blog article was written during Dr. Schröder's position at Bergman Clinics in Naarden. He is currently working at the Park Medical Center in Rotterdam.

Operatie met behulp van een robot

Toys for boys of revolutionaire doorbraak?

For as long as mankind has existed, innovations have been met with distrust. So naturally, the added value of robot-assisted surgery is attracting some debate, both in the media and among surgeons. The question asked is – do such robots actually add anything to the surgical experience, or are they simply toys for technology-addicted boys? Do they actually benefit patients? And is their use cost-effective? Such assessments have thus far failed to demonstrate conclusively that the Da Vinci robot used in prostate surgery has much added value. (See this article in Medisch Contact of 16 May 2014 for more information on this subject.) However, there is more to robot-assisted surgery than just this one use.

Robot-assisted spinal surgery

Seven years ago Israeli company Mazor Robotics developed a robot to be used in spinal surgery. This small robot, which is the size of a can of Coke, helps surgeons place pedicle screws in a highly accurate manner. When I started working at Bergman Clinics 5 years ago, they purchased such a robot at my recommendation. The results have been nothing short of astounding. I’ve now used this robot in about 140 spinal operations, meaning it has placed 4x140=560 screws. Out of these 560 screws, only one had not been placed ideally. This is an incredible success rate, which can definitely be attributed to the software that makes this robot so uniquely effective.

Robot used to fixate vertebrae
Robot used to fixate vertebrae

The precision with which this device does its job exceeds any other clinical results involving a surgeon choosing the direction of the screws without using his hands, i.e., without robot-assisted navigation. This being the case, use of this mini-robot reduces the number of operations that have to be repeated because screws that were not properly implanted the first time round must be removed. This saves patients some discomfort and helps us save money. Another advantage of this robot is that it can be used in minimally invasive surgery involving screws being inserted through tiny incisions in the patient’s skin. In addition, surgeons using a robot require less X-radiation while performing their operations, which is healthier for both doctor and patient.

Five years ago I was the first surgeon in the Benelux countries to use this robot. The only other people using it at the time were a few surgeons in Germany, Israel and the United States. By now over one hundred of these robots have been sold to American hospitals. A little while ago I was asked to give a presentation on my experiences with the Renaissance robot in Shanghai. I was received with great acclaim, and telling 500 spinal surgeons about my practice in Naarden, a town whose name most people present could not even pronounce, was an impressive experience.

Second generation

By now a second generation of this robot has been released. You know how these things go – you’ve just bought yourself a new iPhone, and a new version will be released. However, I can keep my iPhone for free once I’ve been on a plan for 2 years, whereas this new robot will set the clinic back about half a million euros. I don’t think Santa Claus will give me one if I ask for it. And as far as I’m concerned, the results of my first-generation robot are still so groundbreaking that I won’t mind working with my loyal metal assistant for a little while longer.

Surgery manual

Dr. Schröder is happy to inform you about the surgical treatment of your neck or back condition. He also discusses the possible complications of the procedure with you.

After you've carefully weighed up the pros and cons of the surgery, you can decide for yourself whether you consider your condition serious enough to operate.

View the surgery manual

  • Instructions for after you have left the clinic

    Once you leave the clinic:

    • Make sure that someone comes and picks you up in a car, and refrain from driving yourself
    • Make sure that you recline your car seat
    • Make sure that you are not home alone for the first few days following the operation
    • Allow the wound to heal for the first 2 to 3 weeks
    • You are allowed to shower, as the nurses will give you a waterproof plaster to cover your wound before you leave the clinic
    • You must not drive for 3 weeks, but you will be allowed to sit in the passenger seat while someone else drives you around
    • You are allowed to do whatever you feel up to, as long as you keep listening to your body and stop doing whatever it is you are doing whenever your body tells you to stop

    Your doctor, nurse and/or physiotherapist will provide you with more information on how to look after yourself following the operation.

  • How long will I have to stay at the clinic?

    Depends on the nature of the operation

    The duration of your stay with us will depend on your situation and on the type of surgery you are undergoing. If everything goes according to plan, and if you are undergoing a minor back or neck operation, you will only have to stay with us for one night. If you are undergoing major surgery, such as a spinal instability operation, you will generally have to spend a few nights at our clinics.

  • Swelling after surgery

    Swelling reduced after 2 to 3 months

    After the operation, your wound will swell, which may be painless but may also be a little uncomfortable due to your skin being pulled so taut. Generally speaking, the swelling will subside of its own accord within 2 to 3 months of the operation, and the skin will grow less thick.

  • Medication after surgery

    Following the operation, you will be given painkillers for as long as you need them. You will receive these painkillers in accordance with a set schedule. It is vital that you take your medication at the scheduled times, even when you are not experiencing any pain. In this way, your body will build up a steady level of analgesia.

    Most people will be able to stop taking painkillers a few days after undergoing back or neck surgery. If your painkillers somehow fail to provide you with a sufficient level of relief, we recommend that you notify a nurse as soon as possible. If you were on morphine-like medication prior to your operation, we advise that you gradually cut down on your medication after the operation, if your level of pain allows you to do so, in consultation with your GP. Acute withdrawal may result in adverse events.

  • Post-operative pain

    If you are experiencing an excessive amount of pain, you will receive additional painkillers

    The level of post-operative pain differs from person to person, and from operation to operation. Generally speaking, major lengthy operations will prove more painful than brief minor operations. At our clinics, all patients receive proper painkillers following surgery, as a result of which very few of our patients ever experience a great deal of pain. In consultation with yourself, we will determine your pain score, both at the ward and once you are home (we will call you to discuss this with you). If your pain score is too high, you will be given additional painkillers.

100% insurance covery

Nearly all treatments performed by Dr Schröder are covered by health insurance. This is true for the following conditions: neck hernia, spinal hernia, lumbar spinal stenosis and cervical spinal stenosis.

Read more

Dr Schröder's blog

Dr Schröder regularly publishes new articles on his blog. Read all about spinal hernia, neck hernia, spinal stenosis, neurosurgery and other related subjects.

View all blog posts

  • 18. Thank You, Bergman!

  • 17. New surgical technique for lumbar hernias approved!

  • 16. You can't always get what you want

  • 15. To the world at large

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