‘Robotic surgery leads to faster, painless recovery.
INTERVIEW TRANSCRIPT
WITH
ANAMIKA CHOWDHURY (ALWAYSFIRSTNEWS AND MEDIA WEBSITE COLUMNIST)
Prof Dr Subhash Khanna, Chief Consultant of SwagatSurgical Research Institute is a leading academician,surgeon and pioneer of Robotic surgery in Assam andNE region. He is the President, Association of Surgeons Of Assam (2014), Vice – President, International Col-lege of Surgeons and a former President of Indian As.sociation of GastroIntestinalEndosurgeons.
What is Robotic Surgery and how does it function?
Surgical robots were introduced in mid-twentieth century making science fiction a reality. Today, robotic surgery is one of the most advanced forms of laparoscopic surgery. A surgical robot is a complex machine that works on the principle of Master-Slave configuration that transmits the surgeon’s hand movements to the tip of robotic instruments.The machine is between the operating surgeon and the patient, and like in industria! robots, the surgical robots were needed for their accuracy, precision and speed. Surgical robots have a surgeon console with vision monitors that allow 3D vision of the surgical field. There are two hand-controllers for the surgeon sitting on the console to operate the bedside unit that holds and maneuvers the robotic instruments held by the mechanical arms of the robot, as per signals transmitted by the surgeon from the console computer. The instruments are introduced inside the abdomen or other cavities through the keyholes by the surgeon and held by the mechanical arms of the bedside units. Dissection is done by the surgeon who controls the robotic instruments through the console.
In what ways does it serve Benefits in terms of Medical purpose?
In the last three decades,the world has witnessed the journey of surgical revolution from large cadaveric incisions to tiny keyholes and most of the surgeries are now being performed laparoscopically. Robot is the latest advancement of this surgery where we can reach deeper inaccessible cavities and do micro-dissection and can suture precisely with movements of robotic in-struments superior to the human hand. Besides, some of the surgeries that were con-sidered dangerous to do manually or laparoscopically can be done now with robots. The major benefit is surgery can be less traumatic as robotic arms are much easier to use; the surgeon can control three or four arms at a time and the camera gives him a 3D vision right in front of his eyes, reduces hand tremors and reaches all critical areas of the body that are hard to access. Other advantages include less postoperative,pain, reduced wound infection and early return to work
How did RoboticSurgery helped the Patients during Covid crisis?
Robotic surgery has been proven to be safer during the Covid era as in this surgery, once the keyholes are made, the surgeon operates sitting at a console about 3 to 10 meters away with hardly any staff near the patient,highly reducing the risk of transmission and infection. The robot thus works as a shielding layer physically separating the healthcare worker and patients.
As of now what kind of Surgeries you are executing with Robots ?
Apart from Gastrointestinal and Hepatobiliary Surgery being done by me, my other team members include Head and Neck surgeons,urologists and gynecologists. We are presently doing most of the abdominal surgeries that includes gallstones and complex bile duct stones, Liver surgeries,Hernia surgery, surgery for Gastro Esophageal Reflux(GERD) and Hiatus hernia,gastric bypass, colonic surgery and most of the gynecological surgeries.We shall soon be introducing robotic surgery of thorax including that of thymus,lungs and esophagus, and urology as 60% of all urological surgeries are being done robotically now. ENT and Neuro surgeries both transnasal and transanal are almost going to be there as routine with further advancement of instruments .
What is the scope of Robotic Surgery ,are people aware of the Benefits ?
The scope of robotic surgery is expanding and we shall soon be doing advanced surgeries of spleen, liver, gastric and esophageal cancers, lung surgeries and pancreases regularly. The Future belongs to technology: Robots shall be available soon for robotic endoscopy.We shall soon be removing thyroid, reaching the base of tongue tumor with robots, shall use nano robots and intelligent miniature robots to follow commands,similar to capsule endoscopy that we are doing today.
What type of challenges do you face while doing Robotic surgery?
Any surgery is associated with general anesthesia related and procedure related complications. With the use of complete disposable drapes and entry trocars and many single use instruments, the risk of infection is minimal in Robotic surgery and with wonderful tremor free micro-dissection and suturing the complication rate is reported to be lower and the recovery faster. The equipment failure is rare and hence we have kept back up surgeon console.
What is the future of medical surgery after the Introduction of robots?
The future belongs to technology and most of the treatment shall be technology based. Many more technological advances shall be added to robots, soon we shall be able to do endoscopy with robots, shall perform surgery with the help of organ mapping and delineating between tumor planes, and also between healthy and diseased tissue. We shall deploy 3D printing to print organs, and nano robots controlled by external magnets shall become part of routine clinical practice. Virtual and augmented reality shall be available to project the critical structures within the surgical field masking other .Finally, if I put into simple words my opinion for deploying Robotic Surgery, I shall reiterate that a Robot delivers to a patient the experience of being operated on by a senior surgeon through the hands of a young surgeon.
Dr Subhash Khanna (Gastrointestinal Surgeon in Guwahati, Assam)
Anamika Chowdhury (Columnist)