Robotic surgery

ROBOTIC SURGERIES IN INDIA 

Surgical techniques have evolved considerably in recent decades and nowadays minimally invasive surgery techniques are the most sought after by physicians. Now, operations can be performed with greater precision and precision, requiring minimal surgical intervention, minimal healing, blood loss, and a shorter postoperative recovery time than before. In conclusion, the use of robotic surgery and its results are exceptional.

Patient under superbvision of robotic operating machinary

Apollo Hospitals : the state of the art The da Vinci surgical system is the most advanced technological breakthrough in minimally invasive surgery. With the help of robotic surgeries, patients feel less pain and have faster recovery times and can lead a better life without feeling pain, discomfort, infection or social discomfort.

The Da Vinci Surgical System is a specialized four-armed robotic system used for urology, gynecology, cardiac surgery, gastrointestinal surgery, bariatrics and pediatrics. The robot can help with birth defects, ureteropelvic junction obstruction, uterine and cervical cancers, coronary artery disease, colorectal surgeries, liver disease and more.

In addition to the da Vinci® Surgical System, Apollo Hospitals offers the Renaissance ™ Robotic Surgery System </ a>, specifically designed to treat patients with spinal problems such as scoliosis and spinal deformities. The Apollo Hospitals group is the first in Asia Pacific to offer this technology and this treatment option.

International patients should consult their doctor or make an appointment to find out if robotic surgery is needed. Robotic assisted surgeries are available in four major Indian cities: Chennai, Kolkata, Delhi and Hyderabad.

Advantages and disadvantages of robotic surgeries 

 Vision in 3 dimensions:

Robot2 The system gives the surgeon the feeling that his hands are immersed in the patient's body, even though the surgeon is performing the operation from his remote console. Such a system guarantees a perfect view of the operating field thanks to the use of two cameras ensuring a clearer, clearer 3D vision and an extreme stability. The surgeon can moreover, and at any moment, zoom easily and move at the operative site.

patient on a operating object 

Exceptional precision:

One of the characteristics of the system is "amplification" which allows to homogenize the movements of the hands of the surgeon who thus become finer and more precise. The natural hand shake is eliminated by an electronic filter that controls the instrument. The robotic instruments called "EndoWrist", which the surgeon controls from a console, allow him to reach operating areas that are much more difficult to access with other existing techniques. Thus, the risks of collateral damage causing sequelae complications are greatly limited.

Urology has quickly been able to benefit patients from this technological progress, by applying this technique in particular to the removal of the prostate in patients with cancer. Moreover, the urologists of the Montsouris Institute were precursors by being among the first in the world to perform this type of robotic intervention, considered today as a reference in the field.

Today, other surgical specialties such as Gynecology, Thoracic Surgery, Digestive Surgery or ENT Surgery use the Robot in common practice around the world for the benefit of their patients.

Disadvantages of robotic surgeries

One of the big drawbacks when using these robots during operations is the loss of direct feelings with the patient. Thus, the impasto of the remote manipulator limits the access of the surgeon's assistant to the operating field.

   Moreover, the cost of these robots is also a big bane to its use. Indeed, a robot like "Da Vinci" costs € 1,160,000 and its annual cost is € 68,000. After each intervention, a budget of 1700 € is necessary to restore it. Price is one of the factors that makes it less attractive. The operations are thus selected and for this robot it is most often used for the radical removal of the prostate for localized cancer as well as ureteral surgery. 75% of surgeons said they felt financially limited to accessing a system.

Device for operating the patient

 A survey conducted in the United States for the Journal of Thoracic and Cardiovascular Surgery shows that if 25% of cardiac surgery blocks own the Da Vinci robot, the number of operations entirely or in part with this tool only reached 1,700 per year, or 7.3 operations per robot per year.

 Indeed, a French surgeon recognizes that the robot "is a very good sewing machine", but the Da Vinci robot, "operates only one patient per month". Only 12% of US centers equipped more than 50 interventions annual. 

In France, the Da Vinci who do not operate at the level of the prostate, where they are the most efficient, do only a few operations per year. https://www.youtube.com/watch?v=A78NhZoUkc0

 Only 12% of equipped US centers make more than 50 annual interventions. In France, the Da Vinci who do not operate at the level of the prostate, where they are the most efficient, do only a few operations per year. 

Only 12% of equipped US centers make more than 50 annual interventions. In France, the Da Vinci who do not operate at the level of the prostate, where they are the most efficient, do only a few operations per year.

   Let x be the number of years, the function f represents the expenditures by a robot and the function g the income generated by a robot. The use of this robot "Da Vinci" generates an additional cost of about 2,000 € per intervention. 

Moreover, according to the "Journal of Thoracic and Cardiovascular Surgery", this robot carries out about 7.3 operations a year. So for an operation like prostatectomy which is a surgical removal of the prostate, seminal vesicles and deferential bulbs cost at the base 2100 euros:

f (x) = 1160000 + 68000x

g (x) = (2100 + 2000) * 7 , 3x <==> g (x) = 29930x

So f (x) = g (x) <==> x = -30,47 .... Thus, the number of operations performed by a robot is too little for the price of the robot and its maintenance. Indeed the number of operations per year per robot should increase considerably. If, for example, the robot "Da Vinci" performed one operation a day, the cost of the robot could be reimbursed in one year and the surgeon would begin to make profits from the second year.

                                                                         

   Today very few surgeons are trained to use robots for their operations. So the staff in a clinic that can be used is not always present, the rotation of the surgical teams is not possible. Interventions with the robot are done in relation to the availability of the staff and not the robot.

 In addition, the surgeon must be tech-savvy and must know how to use the robot otherwise the working time would be exponential while the robot has the ability to reduce the working time. For this, the surgeon needs more training and 12 to 18 cases are needed for each surgeon before he feels comfortable performing these procedures.

   Even if the risks of failure of an operation are very rare, but it always subsumes the risk of the breakdown. Indeed, a power failure or a fuse that grid causes the immediate shutdown of the operation and putting the robot off. In this case, the surgeon must continue the operation with his hands and will no longer use the robot. However, these failures are very rare because a clinical genius ensures the maitenance of the élétricité.

   "You fascinate the media, the members of the Academy and the sick with your concepts. But the patients who require a triple coronary bypass with closed chest with the robot, I am obliged to dissuade them.

 Our responsibility is their safety. "" I have never promoted surgical robotics, "says Professor Marescaux. I know the danger of heart surgery! " Indeed this surgeon shows that the type of surgery performed by robot surgeons are limited despite their great technological advances. Areas of use are most often general surgery, neurosurgery and urology.