Report by Pravu Prasad Routray, Bhubaneswar: Who doesn’t dread the very thought of surgery? Performed by skilled surgeons it is necessary and effective, but significant cuts to gain access inside the body lead to a lot of pain and slow healing. Conventional surgery means long hospital stays and long recovery times. Blood loss necessitates blood transfusions and is even cosmetically poor as one is left with scars. About 15 to 20 per cent of the patients do face problems related to the wound and not the actual surgery.
Open surgery with long cuts was the only treatment until Laparoscopy was introduced in the early 1990s when surgeons made small cuts, inserted a tube to reach in with small instruments and operated on the affected organs. Instead of seeing the organs with the naked eye, the images of organs were displayed on a TV monitor captured by a miniature telescope-mounted camera inserted in the body. The patients were able to recover faster than with regular surgery. Laparoscopy, even though a major surgical advancement, has disadvantages such as a mere 2-dimensional view, lack of touch sensation and inability of the instruments to provide fine movement. Suturing is difficult and the surgeons have a steep learning curve to become adept at it.
With multi-disciplinary robotic surgery proving its worth in India over the past six years, Odisha, remains one of the few Indian States that don’t have a single surgical robot.
With a view to familiarise surgeons and hospitals administrators on how computer-assisted surgeries can treat various forms of cancers, particularly in the medical disciplines of Urology, Gynaecology, Thoracic, Gastro-intestinal and Head & Neck Vattikuti Technologies is taking da Vinci Surgical roving robot to hospitals in Cuttack and Bhubaneswar this week.
A da Vinci surgical robot brings in human wrist-like movement with its instruments and offers a 10 times enlarged 3-dimeNsional view. And that is exactly what a tour of a da Vinci surgical robot across India is trying to demonstrate. Surgeons in Bhubaneswar and Cuttack will get a first-hand look at how a surgical robotic works and understand the situations in which its benefits unfold.
The roving robot that simulates an operating room setting will be available to surgeons of Cuttack at SCB Medical College & Hospital, Cuttack (on Aug 9-10) and AIIMS Hospital, Bhubaneswar (on August 11-12) to acquaint themselves of its immense capabilities.
Vattikuti Technologies, distributor of da Vinci Surgical Robots and Vattikuti Foundation, evangelist for robotic surgery, are focused on spreading the use of robotic surgery in India. Vattikuti Technologies has partnered with dozens of hospitals in India since 2011 to install a robotic program and bring about the training of surgeons so that patients and doctors have the choice of robotic surgery when it is applicable and beneficial.
“The 4-armed ‘Roving Robot’ will help surgeons in non-metro locations experience the capabilities of a da Vinci surgical robot in removing cancerous tissue while retaining healthy tissue,” says Gopal Chakravarthy, CEO, Vattikuti Technologies.
HOW IT WORKS?
The da Vinci robot does not, contrary to misconception, go ahead and operate on a patient all on its own. A specially trained surgeon sits at a Surgeon’s console nearby looking into a magnified 3D view of the area to be operated. From here, the fine instruments mounted on the four arms of the surgical robot are guided via tiny incisions into the body to remove and repair damaged or affected tissue. The work is precise and tidy.
Da Vinci Surgical Robot works best for soft tissue surgeries especially with cancerous malignancies.
“Eminent robotic surgeon Dr Imran Hamzawala of Saifee Hospital, Mumbai will highlight the benefits of robotic surgery in an interactive session with surgeons from Cuttack and Bhubaneswar on August 11. Surgeons maintain that robotic surgery causes less trauma as they are in full control of the entire procedure,” says Chakravarthy.
Vattikuti Technologies and surgical robot maker Intuitive Surgical Inc., USA will offer hospitals the da Vinci robot along with instruments required for the next three years at a special price point.
WHY GO ROBOTIC?
With enough skilled surgeons in the world, why would it be at all necessary to use robots for something as meticulous as surgery?
Contrary to myths, robotic surgery still needs skilled surgeons, specially trained in the use of the robot which doesn’t operate alone. Experts allude to Robotic Surgery as Computer Assisted Surgery. The da Vinci Robot is controlled at a special console by the surgeon who has a magnified 3D view of the area to be operated and it is from here that robotic arms are guided to do the job. The advantages, involving soft tissue for cancer patients, are unmatchable:
No cut and open: Robotic surgery is a minimally invasive technique. There is no need to make a long cut to open the body and then stitch it back up. Small incisions allow the robotic arms access without damage. This means little blood loss, no significant pain, reduced chance of infection, and a speedy recovery time. Even post-op care is significantly reduced so that a patient can get out of hospital and back to life and work in a much shorter period of time. It is cosmetically better, especially for head and neck surgeries as it leave no visible scars.
UNMATCHED PRECISION: The precise movements of a robotic arm allow instruments to access difficult to reach areas with ease. Much finer than human hands and fingers — and more infallible — the robot’s arms can do their work very precisely.
MAGNIFIED VIEW: The view that a surgeon gets at the console is ten times magnified and 3-dimensional allowing the doctor to see so much more clearly. This prevents collateral damage and reduces the chances of errors.
BY THE NUMBERS
So far, the number of da Vinci Surgical robots in India stands at 51 installations, manned by 275 trained robotic surgeons in 47 hospitals in 20 cities.
Intuitive Surgical, makers of the da Vinci robot, say that there have been over 3 million da Vinci patients so far, treated by 33,000 plus da Vinci trained surgeons using 4000 plus surgical robots installed over six continents in 64 countries. In fact, every 60 seconds a surgeon somewhere starts a da Vinci procedure.
SPREAD OF CANCER IN INDIA
The spread of robotic surgery is a crying need as the spread of cancer continues relentlessly across India. According to the National Cancer Registry there are 15 lakh new cancer cases every year, a prevalence of over 30 lakh cancer cases at any point of time and over 680,000 deaths a year.
To address the scarcity of trained surgeons and the cost of computer assisted procedures and equipment Vattikuti Technologies and Intuitive Surgical Inc. USA and Vattikuti Foundation will showcase the technology by mounting the surgical robot on a mobile vehicle to simulate an operation theatre setting as it shares with doctors, surgeons and hospital administrators of the immense benefits.