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Robotic Surgery

The application of Robotic technology is one of the greatest revolutions in the medical field.  Robotic surgery is a kind of minimally invasive technique with advanced facilities like three-dimensional vision, and very flexible robotic instruments with a wide range of movements. This enables the surgeon to perform complex surgical dissection with high precision and ease. This facilitates patients to recover faster and with minimal post-operative discomfort.

Robot-assisted surgery has taken the concept of minimally invasive surgeries even further, allowing surgeons to overcome the limitations of traditional laparoscopy by providing enhanced dexterity and improved visualization, ultimately leading to better surgical results and an overall higher quality of patient care. There are several hospitals in the country that provide this service but AINU (Asian Institute of Nephrology and Urology) is considered to be the best robotic surgery hospital in India.

Use of Robotic Surgery

Robotic surgery, with its cutting-edge technology, has a wide range of uses in the medical field, transforming the landscape of surgical practice. Its precision and minimally invasive capabilities make it ideal for delicate and complex procedures. Robotic surgery is frequently employed in urology for tasks such as prostatectomy and kidney stone removal, in gynecology for hysterectomy and treatment of endometriosis, and in thoracic surgery for lung and esophageal operations. Additionally, it is valuable in cardiac surgery for procedures like mitral valve repair and coronary artery bypass grafting. Orthopedic surgeries, including joint replacements, also benefit from robotic assistance, providing patients with improved outcomes and faster recoveries. The ever-expanding list of robotic surgery uses continues to redefine the possibilities of modern medicine, enhancing patient care and well-being. s

1. How does surgical Robot work during surgery?

During a robotic surgery procedure, the surgical robot operates as a Master-Slave system. A highly skilled robotic surgeon sits at the console, where instruments are passed into the patient's body through small keyholes. The robotic surgery process involves the robot precisely replicating the surgeon's hand movements, which are then reflected as accurate instrument movements inside the patient's body in real-time. This seamless integration of the robotic technology allows for enhanced precision and control, making robotic surgery a state-of-the-art option in modern medical practice.

2. Why robotic surgery is superior when compared to laparoscopy or open surgery?

In-Built Magnified 3-D vision in a Robotic system improves visualization and depth perception during surgery.  It is possible because of two high-definition cameras. Surgeons can perceive the high-resolution magnified picture up to 12 times. Hence surgeons can carefully identify tiny structures like blood vessels and nerves. This leads to less blood loss and nerve damage.

Robotic endo-wrist technology: Robotic instrument movements are well articulated, flexible, and wide in range, in fact, maneuverability is far better than the surgeon's hands. And surgeon's tremors are also completely filtered out by the Robot.

3. What are the advantages of Robotic Surgery?

As already mentioned, Magnified 3D vision and Endowrist technology enables the surgeon to perform surgery with great precision. This translates into minimal blood loss, less post-operative pain, and quick recovery. The patient can resume routine activities at the earliest. Surgery is done via keyholes and hence better cosmesis.

4. When is Robotic Surgery Needed? Modern Treatment Provided By Our Expert Robotic Surgeons at AINU?

Robotic surgery has the maximum utility in Urological procedures.

For instance, a surgical robot is very much useful to perform the surgical removal of small kidney tumors without damaging healthy kidney tissue. This procedure is called Robotic Partial Nephrectomy or Nephron sparing surgery.

The advent of surgical robots also has changed the landscape of the management of localized prostate cancer. In the past, Prostate cancer surgery used to be very challenging because of the difficult anatomical location. As the prostate is located deep inside the pelvis, surgical access and maneuverability used to be very difficult. Now, with surgical robot prostate surgery can be performed with ease. Robotic camera and instruments can be brought closer to the target organ and perform surgery with great precision. 3-D magnified vision further improves depth perception. Hence tiny nerves around the prostate can effectively be spared by various nerve-sparing techniques. sparing these nerves helps to minimize urine leak (Urine incontinence) as well as sexual dysfunction (Impotence) after prostate cancer surgery.

Other complex Robot-assisted surgeries routinely being performed at AINU are- Robotic radical cystectomy and intracorporeal ileal conduit, Robotic Nephro-ureterectomy, Robotic pyeloplasty, and ureteric reconstructions.

Risks Associated With Robotic Surgery

Robotic surgery, a cutting-edge medical technology, has revolutionized the field of minimally invasive procedures, offering benefits like increased precision, smaller incisions, reduced pain, and faster recovery times. However, it is essential to recognize that like any medical intervention, there are risks associated with robotic surgery.

One of the primary risks of robotic surgery is technical malfunctions or errors in the robotic system. While advancements in technology have minimized these occurrences, they can still happen. A failure in the robotic arm's movements or communication could lead to unintended tissue damage, bleeding, or other complications during the surgery.

Another concern is the learning curve associated with using robotic systems. Surgeons require extensive training to master the robotic surgical techniques. In the early stages of adoption, there may be a higher risk of surgical errors or complications as surgeons become familiar with the equipment and refine their skills.

Moreover, the reliance on technology introduces the risk of system failures or power outages during the procedure. While surgical teams are trained to handle such situations, any interruption in the robotic system could delay the surgery or lead to adverse outcomes.

Additionally, the cost of robotic surgery is a significant factor. The initial investment in the robotic system and ongoing maintenance expenses can lead to increased healthcare costs. If not appropriately managed, these expenses may limit patient access to the benefits of robotic surgery.

Lastly, there may be an over-reliance on technology, potentially leading to a lack of haptic feedback. Surgeons might not have the same tactile sensitivity as in traditional surgery, which could result in a reduced sense of touch during the procedure.

In conclusion, while robotic surgery presents numerous advantages, it is not without its risks. Technical malfunctions, the learning curve for surgeons, system failures, increased costs, and potential lack of haptic feedback are among the risks associated with this advanced medical technique. To ensure the safe and successful implementation of robotic surgery, ongoing training, rigorous quality control measures, and strict adherence to best practices are essential for surgical teams.

Our Robotic Surgeons

The Asian Institute of Nephrology and Urology (AINU) in India is a world-class hospital specializing in renal sciences. Established in 2013, AINU quickly earned NABH accreditation within two years, showcasing its commitment to high-quality care. AINU's expertise in robotic surgery is renowned, particularly in the field of prostate-related conditions, making it home to some of the best robotic surgeons for prostate in India. Their team of skilled surgeons utilizes state-of-the-art equipment across 19 operating rooms, ensuring exceptional clinical outcomes.

The Department of Urology at AINU is a sought-after referral center for complex endoscopic and laparoscopic procedures, offering comprehensive treatment for various urological conditions, including stone disease, urology cancers, reconstructive surgery, and more. In addition, the Department of Nephrology provides advanced care for acute and chronic renal diseases, alongside a world-class dialysis unit.

With a presence in Hyderabad, Secunderabad, Vizag, Siliguri, and Chennai, AINU brings top-notch medical and surgical services to patients across India. Their commitment to cutting-edge technology, highly qualified teams, and outstanding patient care solidifies AINU's position as a leading super-specialty hospital in the region.

Frequently asked questions:

Robotic surgeries are performed after general anesthesia (Complete body anesthesia) and hence patients do not have pain during surgical procedure. Since the procedure is done via small keyholes, patients experience very minimal pain after surgery and are easily managed by low-dose pain medication. Patient is expected to recover early due to less pain.

Surgical Robot is merely a tool with advanced features. The robot does not and cannot perform surgery on its own. As already described, It works by the Master-Slave principle. The computer system in the surgical robot translates surgeon movements exactly with great precision. A trained Robotic surgeon controls the Robot throughout the procedure.

Robotic surgery definitely minimally invasive, as the surgical procedure is performed via small keyholes similar to laparoscopy. However Robotic surgery uses advanced technology over laparoscopy in terms of image quality and depth perception due to 3-D magnified vision;   precision, speed, and range of motion due to advanced flexible instruments.

The cost of Robotic surgery varies based on multiple factors. i.e. complexity of the surgery, duration of the procedure, type of hospital, and number of instruments used during the procedure. Cost is relatively higher when compared with open or laparoscopic surgery.  However, benefits are also much higher with robotic surgery which made it most sought after.

The duration of robotic surgery varies depending on the complexity of the surgery and the experience of the surgeon. Most of the urological procedures, for instance, robotic radical prostatectomy or partial nephrectomy take a couple of hours from docking to undocking of the robot.

Quick and comfortable recovery is a major advantage of Robotic surgery. It is possible because of small keyhole incisions, precise surgical dissection, less collateral damage, and minimal blood loss. Usually, patients are made to walk on the first postoperative day and discharged in stable condition on the second or third postoperative day.

In recent years many hospitals procured surgical robots and they became a mandatory asset in standard tertiary care hospitals. When it comes to the volume and variety of robotic surgeries, AINU is leading way ahead of among the single specialty urology hospitals.

In 2000, Intuitive’s da Vinci Surgical System was the first robotic surgery device to gain FDA clearance.  It is still a leading system, not only in India but also across the globe, in spite of the recent introduction of various other robotic systems. AINU is equipped with newer generation Intuitive’s da Vinci X Surgical System, possessing advanced technology and refined instrumentation.