Technology is revolutionising the medical field with the creation of robotic devices and complex imaging. Robotic surgery, computer-assisted surgery, and robot-assisted surgery are terms for various technological developments that are developed to support a range of surgical procedures.
Robot-assisted surgery 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. In simple words robotic surgery is microsurgery in which the surgeon performs surgery by manipulating the hands of a robot
"Robotic surgery in India 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. In addition, surgical robots have become the entry fee for centers wanting to be known for excellence in minimally invasive surgery."
A robot performing surgery sounds like a scene out of a Hollywood sci-fi flick. But fiction is fast turning into reality in Indian operation theatres where high-precision robotic surgeries – a less cumbersome procedure than conventional operations – are gaining acceptance. Leaving behind the days of low technology methods, doctors are now ushering in a new era of medical treatment successfully. Robotic surgery is the next major revolution in the field of surgery since the discovery of anaesthesia. So far more than 60 chest surgeries have been performed through robots in India. Earlier, the use of robotic surgery was confined to the field of cardiology. However, the doctors soon discovered that it was much more useful for other surgeries.
During the procedure, a surgeon is seated at a console that contains several advanced controls, not unlike video game controllers (though much more advanced). This console also contains a monitor on which she can view the patient through one or more video cameras. At the patient’s side, the robotic apparatus is guided by the surgeon—from first incision, through all of the surgical maneuvers, and then finishing with the closing sutures. The "robot" is equipped with various robotic arms, specialised gripping devices and laparoscopic cameras to provide the surgeon working at the console full control of the surgery. Since the surgeon is always present during the procedure, one obvious question that arises (even from other surgeons) is: why perform robotic surgery at all? Apparently the robotic arms allow for unprecedented control of the surgical area. The movements of the surgeon’s hands are captured, filtered, and transmitted to the robot to provide fluid movements while minimising tremor and unwanted motion. Initial use of robotic surgery has been highly successful and the rate of complications has been quite low. Patients, while somewhat apprehensive at first, appreciate the success and quick recovery from robotic surgery.
Currently there are three types of robotic surgery systems available in India: Supervisory-Controlled systems, Telesurgical systems and Shared-Control 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 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 visualisation 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.
• 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 recognise safe, close, boundary and forbidden territories within the human body. Safe regions are the main focus of the surgery.
Robotic surgery in India is used for a number of different procedures, including
:
• Coronary artery bypass
• Cutting away cancer tissue from sensitive parts of the body such as blood vessels, nerves, or important body organs like prostate
• Gallbladder removal
• Hip replacement
• Hysterectomy
• Kidney removal
• Kidney transplant
• Mitral valve repair
• Pyeloplasty (surgery to correct ureteropelvic junction obstruction)
• Pyloroplasty
• Radical prostatectomy
• Tubal ligation
• Gastric Bypass
Robotic surgery cannot be used for some complex procedures. For example, it is not appropriate for certain types of heart surgery that require greater ability to manipulate instruments in the patient’s chest.
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