Becker's ASC Review

79 ORTHOPEDICS Spine technologies ASCs should acquire in the next 3 years By Alan Condon A s spine surgery continues to accelerate to the outpa- tient setting, five spine surgeons recommend essential technologies for ASCs to invest in. Question: What spine technologies should ASCs in- vest in over the next three years as cases accelerate toward the outpatient setting? Brian Gantwerker, MD. Craniospinal Center of Los Angeles: If I were running or choosing tech for an ASC, I would discuss with our surgeons where they feel they can do the best, most efficient work. Certainly the bread and milk should be a good quality fluoroscope that can double as an intraoperative CT scanner for navigation. Another worthwhile purchase is a spi- nal exoscope. ey tend to be a fih of the cost of a microscope. Also, to try to attract patients from other places, a solid spinal endoscopy system I think will allow physicians to market them- selves as well as the center. John Burleson, MD. Hughston Clinic Orthopaedics (Nash- ville, Tenn.): First and foremost, augmented reality. I think this really is the future of specialized orthopedic and spine surgery. Robotics might be the answer in the future as well, but over the next three years, the price point doesn't make sense for most surgery centers. Sanjay Khurana, MD. LA Spine and Orthopedic Institute (Los Angeles): As the majority of elective spine surgery migrate to the outpatient arena over the coming decade, surgeons will need access to technologies that allow higher-acuity surgeries to be performed with precision and predictability in the least traumatic manner. Intraoperative imaging that allows real-time 3D navigation, whether with a pre-op CT scan or an intra-op CT spin, will allow surgeons to perform fusions and motion- preservation surgeries with full confidence in desired interbody device as well as posterior instrumentation placement. Whether this is done with the assistance of a robot or done manually, the ability to confidently predict or actually visualize postopera- tively will be paramount. Endoscopy and advanced microscopic technology will also be critical in these surgeries for careful and minimally invasive neurological decompression. e exciting forefront of coupling endoscopic/microscopic technologies with advanced imaging and AR speak to an even more promis- ing future for patients and physicians. Rojeh Melikian, MD. DISC Sports & Spine Center (New- port Beach, Calif.): I believe it will be important for ASCs to invest in navigation and robotic platforms that allow for increased complexity of instrumented cases to be done in an outpatient setting. Andrew Hecht, MD. Mount Sinai Health System (New York City): Intraoperative imaging, navigation, robotics and endos- copy. n Stryker CEO sees increased demand for robots in the ASC By Laura Dyrda K evin Lobo, chair and CEO of Stryker, is surprised at how interested ASCs have been in Mako, the com- pany's robotic technology for knee surgery. "Frankly, a few years ago, we didn't realize that Mako would be as popular in the surgery center as it's proving to be," he said during the second quarter earnings call July 27, as transcribed by Seeking Alpha. While Mr. Lobo said Mako utilization has remained flat in hospitals, he is seeing a lot more demand in surgery centers. "A lot of [orthopedic surgery] volume is starting to shift towards surgery centers, and for us it's been a real tailwind," Mr. Lobo said. "Our ASC offense is performing extremely well. There is a larger percentage of the Makos that are going into surgery centers." Mr. Lobo also spoke about Stryker's progress with its ASC suite of products, launched in 2020. The company offers partnering centers to provide everything from operating tables to instruments, power tools, implants and operating room design consultations for efficient orthopedic and total joint procedures. Stryker also launched its "Knee in a Box" product with Conformis, which is designed for ASCs. The box includes Stryker's Triathlon AS-I knee implant with personalized cut- ting guides for the procedure, which reduces steps in the sterilization process. "We have a very custom designed approach to selling to the ASCs," Mr. Lobo said. "It has required a different approach, and we're really excited about the way [we are] working in the market." n Minnesota surgery center debuts Medtronic spinal cord stimulator By Carly Behm M edtronic's recently approved spinal cord stimulator, Vanta, debuted at Duluth, Minn.-based Lakewalk Surgery Center, according to a July 29 LinkedIn post. Chris Davies, MD, reportedly was the first to implant Vanta, according to a Medtronic sales representative. Dr. Davies works on the anesthesia/pain management team at the surgery center. Vanta is a recharge-free implantable device with a battery life of up to 11 years. It has Medtronic's SureScan technol- ogy and AdaptiveStim. The device received FDA approval in June. n

• Cover