Surgical robotics is a new technology that 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. Up to this point in time, however, the drive to develop and obtain robotic devices has been largely driven by the market. There is no doubt that they will become an important tool in the surgical armamentarium, but the extent of their use is still evolving. This surgery is a new and exciting emerging technology that is taking the surgical profession by storm. Up to this point, however, the race to acquire and incorporate this emerging technology has primarily been driven by the market. Moreover, robotic devices seem to have more of a marketing role than a practical role. Whether or not robotic devices will grow into a more practical role remains to be seen.
What is Robotic Surgery?
Robotic surgery, computer-assisted surgery, and robot-assisted surgery are terms for various technological developments that currently are developed to support a range of surgical procedures. It 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 an integrated tremor filter and the ability for scaling of movements.
Why Robotic Surgery?
Robotic surgery is a type of procedure that is similar to laparoscopic surgery. It also can be performed through smaller surgical cuts than traditional open surgery. The small, precise movements that are possible with this type of surgery give it some advantages over standard endoscopic techniques. Sometimes robotic-assisted laparoscopy can allow a surgeon to perform a less-invasive procedure that was once only possible with more invasive open surgery. Once it is placed in the abdomen, a robotic arm is easier for the surgeon to use than the instruments in endoscopic surgery. The robot reduces the surgeon’s movements (for example, moving 1/2 inch for every 1 inch the surgeon moves), which reduces some of the hand tremors and movements that might otherwise make the surgery less precise. Also, robotic instruments can access hard-to-reach areas of your body more easily through smaller incisions compared to traditional open and laparoscopic surgery.
What are the Types of Robotic Surgery?
Following are the types of robotic surgery systems:
Supervisory-Controlled systems: (a.k.a. Computer Assisted Surgery) are the most automated of the three. The surgeon undertakes considerable prep work, inputs data into the robotic system, plans the course of action, takes x-rays, tests the robot's motions, places the robot in the appropriate start position and oversees the robotic action to ensure everything goes as planned. The most famous prototype is the RoboDoc system developed by Integrated Surgical Systems, which is commonly used in orthopedic surgeries.
Telesurgical systems: The Telesurgical robotic system is the second type of device used in modern robotic surgery. The most common variety, the Da Vinci Robotic Surgical System, enhances the surgery by providing 3-D visualization deep within hard-to-reach places like the heart, as well as enhancing wrist dexterity and control of tiny instruments. This technology allows surgeons to make quicker, more controlled and more accurate movements by using the robot arm with its wider range of motions. It also allows more surgeons to perform these procedures, since many of the techniques performed by robot assistants are highly skilled and extremely difficult for humans to master. Now more procedures (like artery repair and valve repair) can be done without long recovery times or bodily injury.
Shared-Control systems: The Shared-Control System is the final category of robotic surgery devices. In this system, the human does the bulk of the work, but the robot assists when needed. In many cases, the robotic system monitors the surgeon, providing stability and support during the procedure. Before getting started, the surgeons program the robots to recognize safe, close, boundary and forbidden territories within the human body. Safe regions are the main focus of the surgery. Through forced feedback in the surgical tools, the system will limit their use within the appropriate area. As with supervisor-controlled systems, there is some setup required by the surgeon prior to the procedure to define the regions of the surgical field.
Robotic Radiosurgery Systems: Robots are also used in delivering radiation for the treatment of tumors. These systems use robotics to control highly focused beams of ionizing radiation to precise locations within the body. Medical imaging first locates the tumor and a map of the area to be treated is created. A series of commands are then entered by the physician into the system to instruct it how to deliver the treatment. The patient is then registered with the system for proper positioning of the body and the treatment is begun. The robotics will then follow the commands to precisely deliver a series of doses to the tumor. This reduces the risk of damage to surrounding tissues.
Applications of Robotic Surgeries
Robotic surgery is particularly useful in certain situations or surgeries. For example, in laparoscopic surgeries, or surgeries in which a laparoscope is used, the arms of the robot are extremely helpful. The most common procedures are:
RY gastric bypass for obesity,
Esophageal Myotomy for achalasia,
Nephrectomy for transplantation and bile duct surgery
Mediastinal Tumor Resection
Biventricular Resynchronization Epicardial Leads
Atrial Septal Defect Repair
Mitral Valve Repair
Coronary artery bypass
Cutting away cancer tissue from sensitive parts of the body such as blood vessels, nerves, or important body organs
Mitral valve repair
Pyeloplasty (surgery to correct ureteropelvic junction obstruction)
Common Robotic Procedures
Robotic Abdominal Surgery: Surgeons use robot-assisted techniques for abdominal procedures ranging from gallbladder and appendix surgery to hernia repair and treatment for rectal cancer. Most patients, who undergo robotic procedures experience significantly less postoperative pain, leave the hospital sooner and return to normal activities more quickly. For people with rectal cancer, robotic surgery can also help prevent damage to vital nerves and tissues. In the past, it was difficult to treat cancers in the lower part of the rectum without removing the anal sphincter, the muscle that controls elimination. This meant that some patients needed an artificial opening in the abdomen to eliminate waste (colostomy). But that changed with the advent of robotic surgery. Because robotic arms are more flexible than standard laparoscopic tools and allow greater precision in difficult areas, experienced surgeons now can often spare delicate nerves to preserve sphincter control and sexual and urinary function.
Robotic Cardiothoracic surgery: This approach enables your surgeon to reach your heart through small incisions in the side of your chest wall rather than by splitting open the breastbone. Avoiding a long chest incision reduces pain and recovery time so you resume normal activities sooner. Robotic surgery also leaves smaller, less noticeable scars than open chest surgery, has a lower risk of infection and may lessen blood loss. Robot-assisted surgery can treat heart problems that are present at birth as well as those that develop later in life. The robot technology is used to repair heart valves and congenital heart problems, including atrial Septal defects and atrioventricular canal defects. It is performed without splitting the breastbone or stopping your heart, robotic off-pump bypass usually means fewer complications, less postoperative bleeding, a shorter hospital stay — often just 48 hours — and quicker recovery. Robotic off-pump bypass also offers more durable results, sparing you repeat operations, and extends the option of bypass surgery to people who might not otherwise be candidates for the procedure.
Robotic Gynecologic surgery: this is done using the da Vinci robotic system for gynecologic surgery and assisted in the process. The use of the system has led to safer, more effective, less intrusive treatments for a wide range of pelvic disorders affecting women. These include:
Pelvic organ prolapse, especially vaginal prolapse and paravaginal defects
Uterine cancer; vaginal fistulas
Because robotic technology helps surgeons operate and suture with greater accuracy and flexibility, many women experience markedly less postoperative pain, reduced scarring and a faster return to normal activities. Depending on your age and the procedure, robotic surgery may also help preserve your fertility and improve reproductive health.
Robotic Head and Neck surgery: Is a new robotic procedure performed through the mouth (transorally) to treat cancers of the tongue base and tonsils. Transoral robotic surgery offers many advantages over conventional head and neck procedures. The maneuverability and precision of the robotic arms help surgeons operate more easily in the small spaces of the mouth and throat. Robotic surgery also offers far better visualization of tumors. The ability to operate in multiple directions and to see in three dimensions helps surgeons effectively eliminate cancer while sparing healthy tissue, reducing complications and improving quality of life. Most patients who undergo Transoral robotic surgery also undergo a simultaneous open operation to remove lymph nodes in the neck. Even so, the majority of patients leave the hospital in about three days and are able to swallow within two weeks — much sooner than is common with other treatment methods. Studies of Transoral robotic surgery show that most people have excellent outcomes.
Robotic Urologic surgery: is the procedure in which your surgeon removes the prostate gland and surrounding lymph nodes through five or six small abdominal incisions. One of the most notable advantages of this approach is fewer traumas to delicate tissues and reduced blood loss. Less than 1 percent of men who undergo robotic prostatectomy require a transfusion, as opposed to 5 to 15 percent of those who have open prostate surgery. The result is a faster, less complicated recovery. The enhanced precision of robotic surgery also makes sparing vital nerves easier and reduces the likelihood of complications such as sexual or urinary dysfunction. The patients who are candidates for traditional open or laparoscopic surgery are also candidates for robotic prostatectomy. Robotic surgery offers outcomes similar to those of standard laparoscopic surgery, with less tissue trauma and blood loss, reduced risk of infection, and significantly faster postoperative recovery. You can expect one to three days of hospital recovery following robotic surgery, as opposed to traditional open surgery, which usually requires a stay of up to five days.
Benefits of Robotic Surgery
Robots in the field of surgery have dramatically changed the procedures for the better. The most significant advantage to Robotic Surgery to the patient is the decrease in pain and scaring. The Robotic System is changing surgical procedures, which may improve both the patient's experience and surgical outcomes. It reduces trauma to the patient by allowing surgery to be performed through small ports or "keyholes" rather than large incisions, resulting in shorter recovery times, fewer complications and a reduced hospital stay. By integrating computer-enhanced technology with the surgeon’s expertise, the da Vinci System enables surgeons to perform extremely delicate and precise minimally invasive surgery (MIS).
The patient may experience the following benefits
Reduced trauma to the body
Often less blood loss and need for transfusions
Less post-operative pain and discomfort
Less risk of infection
Shorter hospital stay
Faster recovery and return to normal daily activities
Less scarring and improved cosmesis
The surgeons have the following benefits
Enhanced 3-D Visualization
Greater Surgical Precision
Increased Range of Movement
Simplifies many existing MIS surgical techniques
Makes difficult MIS operations routine
Makes new MIS procedures possible in most surgical specialties
Complications of Robotic Surgery
Possible reasons that can lead to unsafe operation of a medical unit include flawed design, malfunction of hardware and software components, misinterpretation and incorrect or inadequate specification. As in many other applications, improving some of these parameters results in a degraded performance in other areas, while an overall increased level of safety is accompanied by an increase in cost, complexity, or both
Before Robotic Surgery
You cannot have any food or fluid for 8 hours before the surgery. If you are having certain types of abdominal surgery, your surgeon may recommend that you cleanse your bowels with an enema or laxative the day before surgery.
Stop taking aspirin, blood thinners such as warfarin (Coumadin) or Plavix, anti-inflammatory medications, vitamins, or other supplements 10 days before the procedure.
After the Procedure
You will be taken to a recovery room after the procedure. Depending on the type of surgery performed, you may have to stay in the hospital overnight or for a couple of days. You should be able to walk within a day after the procedure, depending on what type of procedure was done. Avoid heavy lifting or straining until your doctor gives you the okay. Your doctor may advise you not to drive for at least a week.
Because the surgical cuts are typically smaller than with traditional open surgery, robotic surgery may lead to:
Less pain and bleeding
Less risk of infection
Shorter hospital stay
Robotic surgery in India
Indian healthcare is growing day by day and it has marked new level of success. The Indian doctors have the credit of performing the country's first robotic surgery for prostate cancer. India is gaining popularity internationally due to the robotic surgery in India at very low cost along with world class medical amenities with best results. These factors have driven thousands of international patients from all across the globe for various medical treatments including the Robotic surgery in India.
Having the industry's most elaborate and exclusive Patient Care and Clinical Coordination teams stationed at the Indian hospitals, they provide the patients the smoothest and seamless care ever imagined. With a ratio of one Patient Care Manager to five patients our patient care standards are unmatched across the sub continent. The various medical treatments and surgeries performed in India are available at hospitals in the following cities with latest amenities and state-of-art-facilities.
The additional warmth and care the global patients receive while going for various medical treatments and surgeries surpasses all the value added services they avail at their respective places.
Robotic Surgery Cost in India
Advanced methods of treatment are available in India at pocket friendly prices. India offers outstanding medical services at 60-80% less than prevailing USA rates. Even with travel expenses taken into account, the comprehensive medical tourism packages still provide a savings measured in the thousands of dollars for major procedures. The following cost comparison is a good curtain raiser for patients looking for medical services in India.
Procedure Cost (US$)
Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care: it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers. Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh offers best medical tourism service.
Mumbai - Mumbai, formerly known as Bombay in English, is the capital of the Indian state of Maharashtra. This port city (India's largest and busiest) accounts for a major share of the government's revenue, and has one of the world's largest harbour. There are many things to love about Mumbai. One is simply the geographical names, like The Queen's Necklace and Elephanta Island, all with roots in the British Empire.
Hyderabad - Also known as City of Nizams. The city of Hyderabad has its own individual character, which is evident in the beautiful, ancient palaces and the equally modern, and state-of-the-art offices and buildings. Medical tourism at hospitals in Hyderabad combines care for your health with international tourism. The primary reason behind its surging popularity is better healthcare services at an affordable budget.
Goa - Popularly known as the ‘Rome of the East’, Goa boost of natural, magnificent churches and exquisite works of man. Plunge into the clear blue water of the large pool, or soak in the blissful sunshine on the picturesque island. Goa is an interesting location for getting your health propped up and getting those long postponed surgeries done. You have modern facilities, short waiting times and very affordable prices for procedures, hospital services and medicines.
Bangalore - The progressive and modern city of Bangalore is the state capital, being located within India's Karnataka state. Bangalore is often referred to as the country 'Garden City', due to its high concentration of parks and green spaces. Bangalore has few of the world’s best doctors and medical practitioners, who have been trained by the rigorous Indian medical education system as well as in countries like UK and USA.
Nagpur - Nagpur City has many distinctions. It is also the second greenest in India and is located at the very center of the heartland, almost equidistant from Kolkata, Chennai and New Delhi and Mumbai. The present city was founded in the early 18th century by Bhakt Buland, a Gond prince of the kingdom of Deogad in the Chhindwara district. The Nagpur District has a varied culture, as well as being in the central part of India, the market in Nagpur is flooded with products from all over India. Nagpur has few of the world’s best doctors and medical practitioners, who have been trained in countries like UK and USA.
Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala – better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the planet.
Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-packed burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors.
Pune - Once referred to as the Oxford of the east, Punecontinues to be a stronghold for academics and culture. An array of factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international standards and many more have made Pune one of the top destinations for medical tourism.
Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in India.
Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest, including robotic surgery.
Gurgaon - Located in the National Capital Region, Gurgaon is one of the most rapidly growing cities in Greater Delhi. In the last few years Gurgaon has boomed as the hub of IT and other new-age businesses. Gurgoan is the latest destination for Medical Tourism in India as it is the latest modern upcoming city near Delhi.
Chandigarh - Located near the foothills of Shivalik range of the Himalayas, Chandigarh is one of the most beautiful and happening cities of India. Chandigarh has great potential for Medical tourism as the unpolluted and excellent environs give many opportunities to patients to recover from their illness.
Some of the common countries from which patients travel to India for surgery are:
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