When a 66-year-old lecturer from Hosapete was advised knee replacement by doctors for his chronic pain, the first question that bothered him was how soon he would be able to get back on his feet.
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“I have heard people cannot walk on their own for at least a month after the surgery. I do not want to depend on others for such a long time,” he told doctors.
When doctors at SPARSH Hospitals, where he was under treatment, told him that his recovery would be less painful and quick with a robotic joint replacement surgery, he opted for it. “His knee replacement was done using Mako Robotic-Arm assisted technology that allows surgeons to reproduce precise bone cuts for patients, every single time, first on a virtual 3D model and then in the operation theatre. He is up on his feet, able to walk on his own within two weeks,” said Ravikumar Mukartihal, Robotic Joint Replacement surgeon at the hospital.
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He said this technology-assisted procedure offers more precision and accuracy with less blood loss apart from shorter hospital stay.
“In case of a knee or hip surgery, Mako System’s software helps create a 3D model of the diseased joint based on the patient’s CT scan. The software then allows the creation of a personalised virtual surgical plan for each patient, based on their specific disease condition. This planning, done even before entering the operation theatre, helps in deciding the most accurate bone cuts and alignment of implants,” Dr. Mukartihal explained.
Various specialities
Robotic surgeries are now offered in various specialities such as organ transplants, surgical oncology, urology, gynaecology, surgical gastroenterology, general surgery, paediatric surgery, and even ophthalmology.
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Vishal Rao U.S., director Head Neck Oncology - Robotic Surgery at HCG Cancer Centre, recalled, “In my formative years all I had at my disposal were two small eyes and two big hands. Today, I have a robot assisting me with one big powerful eye and two small nimble hands.”
Somashekhar S.P., chairman - Medical Advisory Board and Global Director at Aster International Institute of Oncology, said more patients were now accepting robotic surgeries mainly because of shorter hospital stay, low risk of complications, and speedy recovery. “Last year, 100 new robots were introduced in India both in private and public hospitals,” he said.
Smart tools
Naren Shetty, vice-chairman and head of Cataract and Refractive Surgery at Narayana Nethralaya, said robotics-assisted smart tools are used widely in ophthalmology. “Femtosecond laser-assisted cataract surgery – is an innovative bladeless surgical option for cataract patients. In this surgery, a laser machine is used first to make the incisions, create an opening in the lens capsule and break the cataract into smaller pieces. These incisions are precise, consistent and safer than manual incisions,” he said.
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Mohammed Rehan Sayeed, consultant Cardiothoracic Vascular Surgery at Manipal Hospitals (Yeshwantpur and Hebbal), said robotics is extensively being used in cardiothoracic and vascular surgery too. “In case of bypass surgery, the robot assists in taking down the conduits, and without making a large incision or cutting through the breastbone (with a small 5-cm incision),” he said.
A word of caution
Hema Divakar, chair of Well Woman Healthcare Committee at FIGO (International Federation of Gynecology and Obstetrics), said the increasing popularity of robotic surgery can lead to an increase in irrational demand by the patients, mounting undue pressure upon the surgeon. “This may lead to the irrational use of robotic surgery in view of fear of missing out. Besides the cost of the machine, the expenditure incurred in setting up a facility dedicated to robotic surgery is huge. Much more concerning is the recurring cost of the instruments,” she said.
Following this, costs of robotic surgeries remain high. “In fact, as of now, open/laparoscopic surgeries are much more cost-effective than robotic surgeries,” she said.