It marks the most defining moment in the history of medical sciences in South India
 

Hyderabad|India|June '2011:Robot-assisted surgery is now a reality. South India's first robotic facility set up at a cost of around Rs10 crore, will start functioning from June 26th and will be used in both cardiac and non-cardiac surgeries. KIMS (Krishna Institute of Medical Sciences Ltd.), a 500 bedded, upscale, Multi Super Specialty Hospital initiated a drive to use the robot-assisted technology in a bid to benefit and save patients suffering from plethora of problems like Urology (prostate, kidney, and urinary bladder) and Gynaecology surgeries and subsequently add other specialties such as ENT, Cardiac Surgery, Gastro Intestinal Surgery and Liver Resections announced Dr.B. Bhaskar Rao, Cardiothoracic Surgeon and Managing Director & Chief Executive Officer of KIMS, addressing a press conference in city.

Robotic Assisted Surgery is introduced in association with Vattikuti Urology Institute (VUI), Michigan, USA of Vattikuti Foundation, a major global player in propagating the concept of Minimally Invasive Research with a specific focus in robotic surgery. To take robotic surgery to the next level, robotic surgery institutes are established globally. Similarly it associates with KIMS to set up South India's first robotic facility. VUI has performed over 6000 robotic surgeries, more than any other hospital in the world, added Dr. Rao.

Stating further Dr. Rao added that they are organizing robotic surgeries from 26th June to 2nd July 2011 and live workshop for consultants on 29th June 2011 on Robotic Surgery. Dr James Peabody, a leading consultant in Robotic Surgery at Henry Ford Hospital in Detroit, Michigan, U.S.A., will conduct various Urological Surgical procedures including Radical Prostectomy, Radical Cystectomy, Pyeloplasty and Partial Nephrectomy, Ureteral Reimplantation, Urinary Fistulae, Adrenalectomy, IVC Thrombus Clearance, Retroperitoneal Node Dissection, Live Donor Nephrectomy and Hysterectomy for benign conditions.

The major advantage of Robotics assisted surgery is that the incisions made are tiny so the recovery from surgery is extremely quick. Quick healing time is hallmark of this surgery. Rapid recovery from cardiac surgery is not only better for the patient, but it is less expensive for society. Some other major advantages of robotic surgery are precision, miniaturization, decreased blood loss, less pain and lesser hospital stay. The surgery could be conducted quickly and safely with negligible blood loss informed Dr. B.Bhasker Rao.

Further advantages are articulation beyond normal manipulation and three-dimensional magnification, resulting in improved ergonomics. Robotic techniques more useful where surgeons hands cannot reach. And also 360 degree rotation, which through hands is not possible. Thus robots take surgery beyond the limits of human hand. On an average patients leave the hospital two to five days earlier than patients who have undergone traditional open-heart surgery and return to work and normal activity 50% more quickly. This also reduces the number of staff needed during surgery, nursing care. Therefore, the overall cost of hospital stay comes down. So there is no blood loss, so no blood transfusions are required. And use of pain medication too comes down, Dr. Rao explained.

In traditional open-heart surgery, the surgeon makes a ten to twelve-inch incision, accesses the heart by splitting the sternum (breast bone) and spreading open the rib cage. The patient is then placed on a heart-lung machine and the heart is stopped for the length of the surgery. Not only is this a way for bacteria that can cause infections to access the patient’s body, it also leads to a painful wound, which takes time to heal.

The Vattikuti Urology Institute has demonstrated the superiority of Robotic Radical Prostatectomy over other techniques.

95-98% of patients with organ-confined, low volume, low-PSA cancer had negative margins.
95% or more have had no detectable PSA in the blood in follow up visits.
Most patients go home within 24 hours.
Most patients have very little blood loss or pain.
As of 2010, of the 5000+ people who have had Vattikuti Institute Prostactectomy (VIP) procedure, only six went on to die of cancer (less than 2%)

Compared with other minimally invasive surgery approaches, robot-assisted surgery gives the surgeon better control over the surgical instruments and a better view of the surgical site. In addition, surgeons no longer have to stand throughout the surgery and do not tire as quickly. Naturally occurring hand tremors are filtered out by the robot’s computer software. Finally, the surgical robot can continuously be used by rotating surgery teams.

Robot-assisted surgery moves minimally invasive surgery to a new level. Surgical robotics is a new technology that now holds significant promise. Robotic surgery is often heralded as the new revolution, and it is one of the most talked about subjects in surgery today. Unlike conventional laparoscopic surgery, the robotic system provides unprecedented highly magnified, three-dimensional views of the operating field, eliminates tremors in the surgeon's hand movements, allows for greater freedom of motion for instruments, and all motion is intuitive – when the surgeon directs an instrument in a particular direction, it moves in that direction.

Now India has good number of trained robotic surgeons. Once we install a robot, more doctors trained in the procedure will be available. Robotic surgery can be best useful in complex surgeries that cannot be done using traditional procedures like laproscopics, he added.

Surgery is not very costly. It is as cheap as any other laparoscopic surgery, more so ever for certain surgeries, it is lesser cost than laparoscopic surgery. Presently well over 300 to 400 patients visit abroad for these procedures. Now they can save precious foreign exchange on travel, stay abroad etc. We also expect to attract patients from across India and abroad. We expect to serve about 300 to 400 patients a year, informed Dr. B. Bhaskar Rao. Once the technology becomes popular, we expect costs to still come down, more so ever it will sooner or latter be covered by insurance.

The robot that we are going to install is the best and the latest in the country, said Dr Bhaskar Rao, who is a consultant Cardio Thorasic Surgeon with more than 18000 heart surgeries to his credit. We know there is limited scope for such surgeries in India because there are only three or four robotic medical facilities available in the country, he said.

Robot-assisted surgery was developed to overcome limitations of minimally invasive surgery. Instead of directly moving the instruments the surgeon uses a computer console to manipulate the instruments attached to multiple robot arms. The computer translates the surgeon’s movements, which are then carried out on the patient by the robot. Other features of the robotic system include, for example, an integrated tremor filter and the ability for scaling of movements (changing of the ratio between the extent of movements at the master console to the internal movements of the instruments attached to the robot).

Robot is a master slave to the surgeon. It only obeys the orders from the surgeon. It does not do anything on its own. It can never do anything on its own.

The robotic system that made it all possible is the da Vinci surgical robotic system, manufactured by the California-based Intuitive Surgical. The da Vinci System is FDA cleared for a variety of surgical procedures including surgery for prostate cancer, hysterectomy and mitral valve repair, and is used in more than 1000 hospitals in the Americas and Europe and is safe and has proven track record, which patients need not worry about. Robot assisted surgeries are now most sought after surgeries in the most developed nations. And we are not lagging behind.

At present most robotic surgeries are carried out in the United States. But, it is catching up in this region as well. “There are about 50-60 robotic systems in Southeast Asia. Robotic surgeries are regularly performed in Singapore, Malaysia, Japan and Korea. They are carried out in India for almost one year now.

KIMS offers multi-specialty treatment and facilities on par with its global competitors. This hi-tech medical facility has all the services required to handle every medical problem. They are equipped with a 24 hour ambulance service, a round the clock Pharmacy and a diagnostic centre, while providing services that encompass almost all major specialties such as Cardiology, Urology, Nephrology, Dermatology, Gynaecology, etc. KIMS aims to ensure that every need of the patients is met with speed, accuracy, efficiency, and quality.

KIMS is organizing robotic surgeries from 26th June to 2nd July 2011 and live workshop for consultants on 29th June 2011 on Robotic Surgery.