Jipmer performs robotic urological surgeries

Rigorous training preceded the surgical procedure which was observed via a high-definition 3D vision system

July 10, 2017 08:32 am | Updated 08:32 am IST - Puducherry

New venture: The complex surgery was performed on patients with a block in the ureter.

New venture: The complex surgery was performed on patients with a block in the ureter.

Jipmer has started its multidisciplinary robotic surgical service by performing its first robotic urological surgical procedures recently.

A press note said a multi-disciplinary team performed two cases of robotic pyeloplasty.

The team, led by Dr. S.C. Parija, director, comprised Dr. Ashok Badhe, head of the super specialty block and senior professor of anaesthesiology, urologists, led by Dr. R. Manikandan, head of urology, anaesthesiologists, led by Dr. Sandeep Mishra, head of anaesthesiology and Dr. Lenin Babu, additional professor of anaesthesiology.

Nurses and technicians were guided by robotic urologist, Dr. N. Ragavan, consultant urological surgeon, Apollo Hospitals, Chennai.

The complex surgery was performed on patients with a block in the ureter (tube connecting the kidney and the urinary bladder). Each surgical procedure lasted about two-and-a-half hours and the patients have since made a rapid recovery, Jipmer said.

The rigorous training that preceded the procedure involved gaining proficiency in laparoscopic surgical skills and training in robotic surgical methods in operative workshops, on simulators and wet models and training of anaesthesiologists in advanced robotic surgery centres.

Dr. Parija said that in robotic surgery, the surgeon sits at a surgical console like a pilot in a cockpit and operates the four arms of the surgical robot to perform the surgery inside the abdomen. One arm of the robot controls the camera and the other three manipulate the instruments. The entire surgical procedure is observed via a high-definition 3D vision system.

Magnified view

Through the robotic camera the surgeon gets a highly magnified 3D stereoscopic view of the internal organs at the console. The robotic system scales filters and translates the surgeon’s movements into more precise micro-movements of the instruments.

The jointed-wrist design of the robot exceeds the natural range of movement of the human hand. Moreover, motion scaling and tremor reduction further interpret and refine the surgeon’s movements. All these make the surgical dissection and suturing more precise so that the surgeon can perform a complex procedure through the key-hole incisions, he said.

The advantages include performing many minimally invasive surgical procedures with precision resulting in less blood loss, lower post-operative pain, faster recovery and return to work and cosmetically appealing small scars.

The robotic system commissioned in Jipmer is the latest da Vinci Xi Surgical Robotic System, manufactured by US-based company Intuitive Surgical in California purchased at a cost of ₹28.8 crore, the press note said.

Dr. Parija said Jipmer’s robotic surgery services are a first in a government hospital in the region of Tamil Nadu and Puducherry and only the second centre to do so in the entire South India.

Huge cost

A major reason why robotic surgery in India has not progressed at a faster rate is the huge costs that make the facility inaccessible for the common man.

“There is a large role for government institutions such as Jipmer in making this service accessible to a larger number of people,” Dr Parija said.

Once the robotic surgery service is fully established the students in their respective disciplines will get trained and will thereby serve the patients in other centres in the country.

The Standing Finance Committee had earlier approved the₹32.67 crore project for Jipmer to set up a centre for multidisciplinary robot-assisted minimal access surgery to extend the service to people at a more affordable cost.

The SFC has consciously kept the robotic surgery fee in the ₹30,000 to ₹50,000 range, which was about one-fifth the cost in a corporate hospital.

Dr. Parija also said that in the long term, the institution shall also perform a critical evaluation of this technology in newer areas of application through research and facilitate the development of indigenous alternatives to available equipment and infrastructure.

“We hope that with the introduction of indigenously manufactured systems, the cost will come down,” he added.

0 / 0
Sign in to unlock member-only benefits!
  • Access 10 free stories every month
  • Save stories to read later
  • Access to comment on every story
  • Sign-up/manage your newsletter subscriptions with a single click
  • Get notified by email for early access to discounts & offers on our products
Sign in

Comments

Comments have to be in English, and in full sentences. They cannot be abusive or personal. Please abide by our community guidelines for posting your comments.

We have migrated to a new commenting platform. If you are already a registered user of The Hindu and logged in, you may continue to engage with our articles. If you do not have an account please register and login to post comments. Users can access their older comments by logging into their accounts on Vuukle.