New techniques and approaches are introduced in the surgical field all the time.
The tools available to the surgeon don’t always keep up with these procedural innovations. This is especially true when it comes to the components of the OR that are, in some ways, most mundane.
The anterior approach to total hip arthroplasty has been around for several years, but it’s popularity among physicians has been surging of late. There’s a challenge, though, stemming from the design of most OR tables, which aren’t particularly accommodating to the anterior approach.
Mizuho OSI has a specialty surgical table that could change the equation. The Hana Orthopedic Surgery Table is described by the company as a “state of the art fracture table that optimizes the Anterior Approach to Total Hip Arthroplasty.”
To learn more, Surgical Products interviewed Greg Neukirch, vice president of sales and marketing for Mizuho OSI.
How did Mizuho OSI conceive of the Hana table?
The Hana table has a very interesting history. It’s a product that was generated from another product, which is a table we call the ProFx.
The ProFx table was designed in 2003 for pelvic reconstruction and trauma work. And it has become the gold standard of pelvis reconstruction tables in the country. Almost all Level 1 trauma centers have a ProFx because of this uniqueness in how they can be used in pelvic reconstruction and trauma surgery.
It is a very large table — we still have it in practice today. It was designed in conjunction with Dr. Joel Matta, springing from his idea of changing the procedure of hip replacement to an anterior approach and to improve pelvic reconstruction cases.
But because of what Dr. Matta was doing with the anterior approach and what we were looking to do regarding hip replacements, we needed to go into more fundamental orthopedic trauma work and hip replacement. So, we modified the ProFx, and that was the advent of the Hana table.
What’s unique about the Hana table?
What we’ve been able to do with the Hana table is approach the market as an orthopedic trauma table. But we’re also specifically helping change the dynamics of how physicians approach a patient in doing hip replacement procedures.
The anterior approach technique that has been developed and popularized by Dr. Matta involves going through the front of the hip and not cutting any muscle. Physicians using the Hana table have a femoral lift system that allows them to secure the hip and ensure better access to the femur without cutting muscle, and also without going through the posterior muscles and destabilizing the patient’s body for a period of time while they recover.
Because of the way the Hana table facilitates the anterior approach, we feel it helps patient care by reducing pain and improving the recovery time of patients.
Since the table is designed with an innovative surgical approach in mind, what other efforts were required to make it possible for surgeons to make a transition?
We worked closely with our device partners as they changed the implants that go into the hip to make them better suited for the anterior approach. So it really was a multipronged approach into the market to help improve care, beginning with the design of a surgical table.
Our intention was to turn the table from a surgical table into an instrument for the physician. And that’s what we’ve been able to accomplish, not just with the Hana table, but also some of the other tables we’ve created at Mizuho OSI.
How does the design of this table reflect the company approach to the healthcare space?
What’s unique about Mizuho OSI is we have a different philosophical approach than our competitors in the market. We approach the surgical environment to see how we can solve a problem for a physician to improve outcomes for the patient. That’s the mentality we bring into everything we do.
So, all the spinal tables, trauma tables, and the accessories that we make have that larger goal behind the thought processes of our R&D and marketing teams. What problems can we help solve for physicians and bring them a tool to the OR that improves their patient’s experience at the end of the day?
We also make more general tables like the rest of the market does, but our real value to the community is the specialty table portion of our company.
What kind of support do you offer to surgeons who are interested in switching to the anterior approach?
We realize it is an uphill battle for some, because it requires a change in the physician’s technical approach. Physicians were trained for years to go through the posterior, cut the gluteus muscles, and go in to get good visualization.
We’ve committed to help educate physicians on this different procedural approach, which is a massive undertaking. We support over 150 cadaver labs a year to help physicians understand and practice the new procedural approach.
Not only do we make tables, we’re also helping to educate and be part of the process of them getting to understand how to learn do it, the confidence to do it, and practice it.
If a surgeon approached the Hana table for the first time, what would they notice immediately?
First, we incorporate a lot of carbon fiber into our tables, which is unique in the surgical environment. Most tables are made out of stainless steel.
We use carbon fiber because imaging is so important. The physician can take images of their work during the surgical procedure to check on placements, positioning, and alignment.
When you look at the table, it has the classic design of a trauma table. So it’s much more than just a hip replacement table. It’s a true orthopedic trauma table.
How does the Hana help surgeons achieve the precision they need in performing total hip arthroplasty?
The biggest thing when people have a new hip put in is leg length, so when you get off the table you’re able to stand straight and your legs are the same length. We consider body positioning and body movement when we design our products, as well as the ability for physicians to image as they work.
When a physician chooses a hip, they need to be able to look at the positioning and the length of the legs. They need to take images of legs, hips, and pelvis, to make sure that when that patient gets off that table and stands up that the legs are the right length. So for us, patient positioning is critical and the ability to image during surgery is crucial. Those are the really key aspect that we want to make sure we provide a physician: body position, the ability to image the body, and have movement during the surgery.