We’re living in a world where technology has taken over, there is no sphere of humans’ life which has not been invaded by the latest technological developments. Throughout history, disease has been a subject of fear and fascination in equal measure. However, each revolutionary medical discovery has brought us a crucial step closer to understanding the complex mysteries of disease and medicine. Medical science has reached new heights, we’ve found cures for deadly diseases saving millions of lives, we’ve made consistent advances in pharmaceuticals, one other important advancement we’ve made is the emergence of Robotic Surgery. Robotic Surgery, or robot-assisted surgery, allows doctors to perform many types of complex procedures with more precision, flexibility and control than is possible with conventional techniques. Robotic surgery is usually associated with minimally invasive surgery — procedures performed through tiny incisions. It is also sometimes used in certain traditional open surgical procedures.
Robotic surgery has been rapidly adopted by hospitals in the United States and Europe for use in the treatment of a wide range of conditions. The most widely used clinical robotic surgical system includes a camera arm and mechanical arms with surgical instruments attached to them. The surgeon controls the arms while seated at a computer console near the operating table. The console gives the surgeon a high-definition, magnified, 3-D view of the surgical site. The surgeon leads other team members who assist during the operation. It integrates advanced computer technology with the experience of the skilled surgeons. This technology provides the surgeon with a 10x magnified, high-definition, 3D-image of the body’s intricate anatomy. The new high-tech robot, called the Da Vinci Surgical System, is poised to completely revolutionize surgery once again. In some ways, it already has.
Robotic Surgery has many benefits, but, it also brings with it risks and some disadvantages.
One: Smaller incisions and less trauma, the nature of robotic surgery is less invasive, which means the patient experiences less pain and quicker recovery time. The surgical arms are often pneumatic, powered by compressed air and electricity to control the operation. The ‘hands’ of each arm, which hold each of the necessary surgical tools, are also smaller than human hands, which eliminates the need for large incisions.
Two: It has higher surgical accuracy, the robots in robotic surgery aren’t susceptible to the shaking or other strain-related movements a human surgeon might experience. If the controller’s hands are shaking, the machine’s software compensates for that movement, so it doesn’t affect the surgery.
Three: Surgeries, especially ones that take multiple hours, are exhausting for the attending surgeon. The team is on their feet for hours at a time, completing the surgery and attending to the patient. Surgery robots allow the surgeon to sit comfortably while operating. This could help keep surgeons fresh and aware for the duration of their surgeries, preventing fatigue-related errors and reducing the potential for medical malpractice.
Four: Many conditions have been successfully treated using Robotic-assisted surgery, these include – Colorectal Surgery, General Surgery, Gynecologic Surgery, Heart Surgery, Endometriosis, Head and Neck Surgery, Thoracic Surgery, and Urologic Surgery.
One: The expense of surgery, the high cost of installing a robotic surgery system can increase the cost of a surgical procedure. Surgical robots are costly to maintain, and their operation requires additional training, which is also expensive. Exact numbers are difficult to come by, but in general, a surgery utilizing a da Vinci surgery robot will cost between $3,000 and $6,000 more than a traditional laparoscopic procedure.
Two: One of the most significant problems with robotic surgery is the issue of latency — the time it takes for the robot to carry out the surgeon’s commands. It takes a few moments for the computer to communicate with the robotic arms. While this isn’t an issue for routine surgeries, it makes it difficult for surgeons to respond quickly to problems that occur during the operation.
The extent to which robotic surgery has been embraced by the surgical fraternity has been unparalleled. It has been driven in part by rapid developments in technology and in part by the ease with which adaptations have been made to existing laparoscopic procedures and techniques. Robotic procedures are rapidly becoming the new standard of care. As with a number of other technological advances in medicine and surgery, these developments have seldom been introduced as a result of randomised prospective studies.
A US-based company is the world market leader in robotics surgery with no major competition from rivals. Currently, around 300 active surgeons in India are performing operations every quarter using the Da Vinci system at hospitals such as Fortis, Apollo, Columbia Asia and Tata Memorial. Globally, the system has performed over six million successful surgeries so far. The All India Institute of Medical Sciences has been at the forefront of the robotic revolution in India. India now stands at the cusp of a robotic revolution. Robotic surgery in India is here to stay and it is up to us as minimally invasive surgeons across different specialties to lead the way and make maximum use of robotic surgery.
Doctors are anticipating the growth of tele-medicine and long-distance operations, where a doctor could conceivably operate on a patient in another city, state, or even a different continent. Practically, this would mean that surgical centres would be set up in different parts of the world and a doctor could go to a surgical centre and sit in a control console while a patient in a different surgical centre would be operated on by a robot controlled by that doctor.
It’s hard to believe it’s been nearly two decades since Intuitive Surgical launched its first Da Vinci system. And yet, in many ways, the field of robotic-assisted surgery is still in its infancy. With the right expertise and technology, the advantages can eventually overcome the disadvantages. Communication latency is currently the biggest hurdle to overcome to allow this technology to hold a more prominent place in the medical community. Even if the cost of the procedure slows down the integration in hospitals, surgeries with robotic machines will continue to become more commonplace, allowing more precise Microsurgeries with improved accuracy.