Cutting Edge: Da Vinci wrists mean precise, safe surgeries and faster recovery

For some time now, minimally invasive surgery, often involving robotic-aided interventions, has been established as the gold standard treatment for gynaecological, cancer and urological-prostate surgeries. Over the last couple of years, the scope of robotic aided surgery has widened further. It is now recommended for patients suffering from diseases of the prostate gland, kidney, ureter, uterus, ovaries, intestines, stomach, liver, lymph nodes and esophagus. Moreover, it is being increasingly used to treat cancers of the prostate, kidneys, uterus, ovaries, large intestine, esophagus and lymph nodes. It is being increasingly deployed in Pelviureteric Junction Obstruction (PUJO) as well as head and neck surgeries.

Why robotic surgery

Explaining how robotic-aided surgery has transformed healthcare, Dr Manish Ahuja, Consultant, Urology, Robotic and Laparoscopic Surgery, Fortis Hospital, Mohali, says it has helped surgeons intervene with pitch-perfect precision as it provides a 3D view of the operative field via a special camera inserted into the body of the patient. Parts of the body, which are difficult to access with the human hand, can be reached with robot-assisted arms that can rotate 360 degrees. Patients have minimal blood loss, less scarring and the recovery process is faster. “We have completed 250 successful robotic-aided surgeries and have the most advanced fourth generation robotic machine — Da Vinci — which is used to treat diseases in urology, oncology, gynecology and ENT,” he adds.

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How is the surgery conducted

During a robotic surgery, special miniaturised, robotically-controlled instruments are placed in the abdomen via very small cuts. These are under the control of a surgeon sitting on a computerised console. The camera offers a magnified view of delicate structures surrounding the organ to be operated and helps in their optimal preservation. He can then visualise and target the device to the intended organ with that much precision.

Most robotic instruments have a special technology called “EndoWrist,” which provides a greater manoeuverability than the human wrist. This allows a surgeon to manipulate instruments in several directions than open or laparoscopic surgery.

Improved outcomes

A robotic surgical system vastly improves the accuracy of surgery and translates into better surgical outcomes, better cancer control, lesser blood loss, complications, pain, and faster recovery. “Robotic surgery has made some of the standard surgeries much safer and more precise. It has helped surgeons attempt a lot of complicated and delicate surgeries. Newer avenues are being explored by researchers on robotic surgeries. Soon, most of the conventional surgeries on the abdomen will be replaced by robotic surgeries. As this technology becomes widely available, the cost of treatment will become more affordable,” says Dr Ahuja.

Dr Swapna Misra, Director, Obstetrics and Gynaecology, says that at the hospital, robotic surgery is performed to treat uterine cancer, fibroids, endometriosis, vesico-vaginal fistula, ovarian cyst, ovarian cystectomy or ovariotomy, myomectomy and hysterectomy. The post-operative pain relief, shares Dr Misra, has vastly improved as there is less scarring and blood loss. “Robotic surgery is an important advancement in gynaecology and has revolutionised the scope of treatment after laparoscopy. Any surgery that can be done laparoscopically can also be done through robotic surgery.” Due to the benefits of robotic surgery, adds Dr Misra, women can return to their respective jobs faster without discomfort as the recovery process is faster. “Likewise, all cancers — which were previously done with 25-30 cm scars in an open surgery – can now be done with keyhole robot-assisted arms.”