Tuesday 5 May 2015

Why do we need a new technique for Minimally Invasive Heart Surgery?

What is robotic surgery?

This is a surgery performed by surgeons using a computer that controls very small instruments attached to a robot. It is therefore, also referred to as computer assisted Minimally Invasive Surgery (MIS).
Robotic surgery is safe and is performed through very small incisions (fingertip size). Robot itself does not perform surgery, though the name so indicates, this surgery is performed by a surgeon who is assisted by a robot and a computer console. Hence, it’s the surgeon’s dexterity and experience that is key for success of this advance surgical technique 

How is robotic surgery performed?

For this procedure, surgeon sits at a console (computer), from where he controls the movements of fine instruments attached to the robotic arms. Robot acts exactly the way the surgeon does sitting at the console, hence the robotic instruments are under the control of the surgeon – the only difference being that the surgeon’s hands do not directly touch the human body during the surgery. 

What are the benefits of robotic surgery as compared with traditional methods of surgery?

Robotic surgery is technologically more advanced thus it helps surgeons conduct complex surgeries with ease. Robotic arms are steadier, more precise and can access the interior of the human body much easily than a human hand can. Thus, this surgery provides greater precision, increased motion range, improved dexterity to surgeons 

Also the 3D view provided by the camera captures more than a human eye can, thus the enhanced visualization due to 3D effect improves access, quality of surgery and its outcome From patients perspective some of the benefits include-

·         precise operation with higher accuracy
·         shorter hospital stay
·         less pain
·         lower risk of infection
·         less blood loss, thus fewer transfusions
·         less scarring with minimal incisions
·         faster functional recovery

What is the role of the surgeon in robotic surgery?

Like all traditional surgeries, in case of robotic surgery too it is an experienced surgeon who creates successful outcomes. It is the surgeon who conducts these surgeries using a robot and a computer to guide his actions, and he keeps control on all the surgical procedures. Though robot enables technologically advanced actions, they are incapable of replacing a qualified experienced surgeon, thus robot is more of an enabling tool for a deft surgeon.

Is robotic surgery more expensive than traditional surgery?

On an average, a robotic procedure costs about INR 50,000 – 75,000 more than an open/traditional surgery. Since robot is expensive, the additional cost of the surgery is directly attributable to the robotic instruments used for performing the procedure.

All other costs associated remain the same as compared to any conventional, open or laparoscopic surgery. 

At a minimal additional cost, patients benefit with precise operations involving less complications, scarring, blood loss, reduced hospital stay and faster functional recovery- advantages that ensure better quality of life
Is there any difference in the length of stay of the patients undergoing robotic surgery?

Compared to an open surgery, the length of hospital stay for a patient undergoing robotic surgery is much less. Such patients are usually discharged within 2-3 days
Is there a difference in anesthesia given for robotic surgery?

No, the anesthesia remains the same.
Why do we need a new technique for minimally invasive surgery?

Traditionally minimally invasive laparoscopic surgical techniques are most commonly used for routine procedures, but these techniques have their limitations of standard 2D video and rigid instruments that surgeons have to use. Laparoscopic instruments and the video monitor do not provide surgeons with quality visualization required to perform complex surgeries. Through robotic surgery it becomes easier and less time consuming in order to perform complex surgeries.
Considering the limitations of traditional laparoscopic surgical techniques, a new & more advanced technique of minimally invasive surgery is a very effective alternative
What surgeries can be performed with robotic assistance?

 Most advanced minimally invasive surgical procedures using da Vinci SI HD surgical system. Some the surgeries that can be performed using robot are-
·         Robotic Cardiac Surgery for coronary bypass, implantation of lead, valve repair & valve replacement, congenital defects
·         Robotic Urology Surgery for prostate cancer, kidney cancer, bladder cancer, adrenal tumors, nephrectomy, reconstruction of urinary bladder
·         Robotic Gynaecology Surgery for hysterectomy, myomectomy, ovarian surgery, tubal surgery, lymph node removal.
·         Robotic Liver Transplant Surgery for donor liver hepatectomy
·         Robotic GI Surgery for hernia repair, pancreatectomy, gastrectomy, cholecystectomy
·         Robotic Thoracic Surgery for lobectomy, thymectomy, resection of mediastinal mass
·         Robotic ENT Surgery for transoral surgery, complex OSA surgery

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