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New Delhi: Four
finger-tip sized incisions, four robotic arms, including a camera
eye snaking inside, the magnified image of the visceral organs
being watched on a screen outside as the surgical instrument arm
moves deftly to remove the tumour or blockage. Minimal blood loss,
no long hospital stay -- welcome to the revolutionary world of
robotic surgery that is gaining in popularity in India.
Some of the major hospitals in the capital, including the All
India Institute of Medical Sciences (AIIMS), are performing
complex surgeries the robotic way.
Major procedures such as removal of tumours, heart surgery and
gynaecological surgery that would traditionally require the
scalpel to make large and deep cuts in the body and consequent
blood loss are now being done with robotic arms.
"Robotic surgery allows us to do many complex operations that
would require large incisions," Sudhir Srivastava, chairman, CEO
and managing director, Fortis Healthcare International Centre for
Robotic Surgery in New Delhi, told IANS.
Srivastava said conventional cardiac surgery requires splitting of
the sternum, but in robotic surgery, using a robotic surgical
system called Da Vinc, just four-five finger-tip sized incisions
are all it requires.
"The tips of the robotic arms behave like human wrists and allows
us to do complex surgeries through tiny holes," he said.
The camera arm of the robot allows surgeons to see inside the body
in 3D. The image of the internal organs -- magnified up to 10
times in high definition -- shows up on a screen at the surgeon's
console. Using hand and foot controls, the surgeon directs the
robotic arms with the surgical tools to perform the required
procedure.
"The camera acts as the eyes, while the instruments act as the
arms of the surgeon," said Srivastava, adding that the surgery is
"very precise, the incisions are tiny, there is little trauma and
the patient can return home in a day or two. There are less
complications, less blood transfusion and it is cosmetically
preferable".
What about the cost?
The cost varies between Rs.60,000 and Rs.1.5 lakh (approx
$1,000-$2,700), depending on the procedure, he says.
"It works out more expensive than the conventional surgery, but
the benefits are huge because of all the advantages," Srivastava
said.
He says the cost is due to the technology, as each machine costs
about Rs.8-10 crore (approx $1.4-1.8 million), depending on the
model.
He says that robotic surgeries abroad are "10 times more
expensive".
Fortis has two robotic systems and the hospital performs cardiac,
thoracic, urology, gynaecology, general, head and neck and
orthopaedics procedures.
At AIIMS, robotic surgery is done in the field of urology, ENT
cardiac, thoracic and in general surgery, says P.N. Dogra,
professor and head of the Department of Urology, adding that the
urology section gets around 130-140 patients every month.
But AIIMS does not charge anything from general patients. "During
the hospital stay, even the meal charge is not taken from some
patients," Dogra said.
One major advantage of the robotic system, he says, is the "tremor
filtration" in which the "unintentional movement of the doctor is
not carried over to the patients during the operation as the
doctors are behind the operation table monitoring the robot".
Arvind Kumar, a former professor of surgery at AIIMS, who is now
heading the Institute of Robotic Surgery at Sir Gangaram Hospital,
says the hospital performed "Asia's first vascular surgery" using
the robotic system.
Explaining the high costs, Kumar says the robotic technology is in
evolution. "As its uses become more, the prices will crash, like
in the case of mobiles," Kumar told IANS.
(Ranjana
Narayan can be contacted at ranjana.n@ians.in)
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