What is robotic surgery?

The robot adds to the capability of the surgeon to accomplish a surgical task. Still it is the man behind the machine i.e. the surgeon who does the surgery and robot does not do any thing on its own.

In a robot assisted surgery, the surgeon uses the assistance of a robot to perform the surgery using the MIS technique. Robot assisted surgery is a step forward in providing cutting edge treatment & is set to become the standard procedure over the next few years.

The da Vinci Si Surgical Robotic System with Simulator is the latest robotic system to be used to perform surgeries. With the commissioning of the robot, Asian Vattikuti Institute of Robotic Surgery is the pioneering institute in the country & amongst the first few to bring the latest generation robot to this part of the world & is aiming to become one of the pioneers & leader for robotic surgery.

 

How does it differ from normal surgery?

Most of the critical organs or areas of the body which require a surgery are located deep inside body. To reach it, a surgeon has to make a large incision (cut) in the skin, muscles or breast bone (in case of heart surgery) to access the organs and perform the surgery. Though this traditional way of doing surgeries is extremely safe and time tested, the patient suffers from pain, requires more blood transfusion, takes longer to recover (4 to 6 weeks) and many times has a scar.

In a Minimally Invasive Surgery (MIS) or laparoscopic surgery (key-hole), the surgery is done by minimally entering the body. Instead of a large cut, the operation is done through 1 to 2 cm small cuts (key holes), through which the surgeon passes instruments to do the surgery. This has resulted in many surgeries moving from the open surgeries to key-hole surgeries.

Robot-assisted surgery is an advancement over Minimally Invasive Surgery (MIS). Since surgery is done through small incisions of 1 to 2 cm only, the blood loss, trauma and pain suffered by the patient is minimized to a large extent. Moreover, the recovery of the patient is much faster – a patient gets discharged within 2 to 3 days as opposed to the 7 to 10 days needed through the traditional technique. The patient can resume a normal life and go back to work within 5 to 7 days. Also the cosmetic outcome is superior, with minimal scars on the body. The overall precision of the surgery is greater since the robot gives the surgeon better control over the surgical instruments and a better view of the surgical site (the operative field is magnified by about 40 times), compared to other minimally invasive approaches. The naturally occurring hand tremors are filtered out by the computers software thus increasing the precision.

 

How does the robot assist a surgery?

Robot-assisted surgery, commonly known as robotic surgery was developed to overcome the limitations of MIS. The robotic system enables surgeons to perform delicate and complex operations on the heart, kidney, prostrate, gall bladder, ovary, uterus, thyroid, etc. For example, thyroid surgery can be done through the axillary route (through the under arms with no scar on the neck).

The surgeries are done through a few tiny incisions with increased vision, precision, dexterity and control. Several key components of the system include:

Surgeon Console: This is where the surgeon sits while operating. It is located in the same operating room which means that the surgeon is physically present all throughout the surgery. Instead of directly moving the instruments, the surgeon uses the console to move the instruments which are attached to the robotic arms. The computer translates the surgeon's movements, which are then carried by the robot. All through, the surgeon is able to get a high resolution view of the inside of the patient's body.

Patient Side Cart: This is where the patient is made to lie down for the surgery. It includes 4 robotic arms that carry out the surgeons commands. The robotic arms move depending on the movement specified by the surgeon at the console, which means that the operation is under direct control of the surgeon. The robotic arms are fitted with surgical instruments which enter into the body through keyhole incisions of 1 to 2 cm. The robotic system translates the surgeons hand movements into micro-movements of the instruments to perform the surgery. Repeated safety checks prevent any independent movements of the instrument or the robotic arm.

Endo Wrist Instruments: These instruments are attached to the robotic arm and are designed to give a range of movements even greater than the human wrist. An integrated tremor filter detects and filters out any tremors in the surgeon's hand movements, so that they are not duplicated robotically. This further enables the surgeon to perform various surgical operations with a greater level precision.

Vision System: The vision system is equipped with a high-definition, 3D endoscope (flexible tube with a camera and light at the tip) that provides live images of the area to be operated. The surgeon gets a magnified view of the robotic movements which is 20 to 40 times more magnified than naked eye, thus helping the surgeon to do more accurate operations.

 

Has Asian Vattikuti Institute of Robotic Surgery already started performing surgeries?

Yes, we have started in the month of August 2011. We are regularly doing robot-assisted surgeries and have a 100% success rate.

 

Where can I get more information about robotic surgery?

You can call us on +91-22-6698 6538/39 or write to us at info@ahirc.com. We will be more than happy to provide you with the sufficient information.

 

What is the minimum cost?

The cost of surgery will be marginally more than the laparoscopic surgery but this cost is compensated by shorter hospital stay, early return to work, minimal or no blood transfusion, better cosmetic results, less pain with superior results.

 

How safe a patient is in the hand of robot?

There is a common misconception that the surgeon doesn't do anything and it is the robot that operates. As mentioned earlier, robotic surgery is actually robot-assisted surgery whereby the surgeon operates with the help of the robot. The robot doesn't do anything by its own. The surgeon does the entire surgery, with the robotic arms just mimicking the movements of the surgeon's fingers. The onus of the surgery still lies on the surgical team and it is the expertise and experience of the surgeon which still makes the surgery successful.

So you are as safe in the hands of the robot as you would be in the hands of the surgeon

 

Can a child undergo robotic surgery?

There are some criteria on the basis of which a child is selected for robotic surgery. To know more, please speak to our Robotic Surgery Department.

 

Is there any other centre in Mumbai for robotic surgery? Who are they?

In Mumbai, we are the first ones to introduce it.

 

How much time a robotic surgery take?

It depends on the specialty/category of surgery. It takes as much time as a conventional surgery.

 

Where is the robot from?

It is imported from Intuitive Surgicals, USA.

 

Have the doctors undergone training for robotic surgery?

Yes – our doctors have undergone extensive training in UK and France almost for a week.

 

Are patients admitted for robotic surgery for all procedures?

In the 1st phase we are offering robotic surgeries for urology. In the next phase which we plan to start soon, we will be offering robotic surgery for gynecological procedures followed by oncology and gastro intestinal surgeries and cardiac procedures

 

What happens if the robot malfunctions during surgery?

This will be a rare occurrence. But, just incase the machine malfunctions during surgery, the surgeon and the Operation theatre team is prepared to convert the surgery to an open surgery or laparoscopic surgery.

 

How many clinical people will be present during surgery?

As many as there are during conventional surgery – the entire surgical team with all senior doctors are a part of the surgical team

 

Does the robot administer anesthesia?

No. It's anesthesiologist who administers anesthesia

 

Can I opt for surgery by myself?

No. The patient can't opt for a robotic surgery himself. A specialist in the particular field will need to review the patient and his reports to ensure that the patient is suitable for robotic surgery.

 

Are there any special precautions that I need to take before undergoing robotic surgery?

None. There are no special precautions to be taken for a robot-assisted surgery. The precautions remain the same like those for a routine surgery. Pre-op tests need to be done prior to the procedure, which are similar to the tests done prior to a routine surgery. Your Doctor will guide you further on the same.