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30 August 2010
By Anjali Ojha
New Delhi, India

With the robot for chest surgery, the doctors do not need to dissect the whole chest as is the norm in the traditional open chest 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 in Delhi’s premier All India Institute of Medical Sciences (AIIMS) is one of the success stories.

"Robotic surgery is the next major revolution in the field of surgery since the discovery of anaesthesia," Arvind Kumar, head of the department of surgery at AIIMS, told IANS.

So far more than 60 chest surgeries have been performed through robots in India. The robot is also used for urological surgeries like prostate.

"The minimally invasive methods have brought a paradigm shift in the way we operate by making equipments an extension of hands. This reduces the risk of infection and shortens the recovery period," said the doctor who is an expert in minimally invasive general surgery, general thoracic, thoracoscopic and robotic surgery.

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.

"With the robot for chest surgery, the doctors do not need to dissect the whole chest as is the norm in the traditional open chest surgery or to break the rib bones or the sternum bone for operation," Kumar said.

The robot consists of a set of four arms, two to operate, one to hold the camera and the fourth one for assistance. These arms are mounted on a platform and are controlled by the doctor sitting at the control panel. The panel consists of an eye piece which gives a three–dimensional view and two joy–sticks to move the robot’s arms. The movement of the robot’s hands is same as that of the doctor, making the procedure simple.

In robotic operation, only three incursions of 10 mm to 1 cm each are needed, which prevents excessive bleeding and also reduces the rehabilitation period by up to seven times.

"Moreover, the robotic arm is designed in such a way that it can reach the interior part of the organ curvature, which is not possible in the traditional or microscopic surgery without damaging the normal tissues," Arvind Kumar said.

Similar convenience of minimal invasion is also possible through the laparoscopy method in which surgeries are done with the help of a rod like instrument which has a camera and surgical tools attached to its end. The instrument is operated by doctors on the basis of images obtained by the camera.

"Laparoscopy’s shortcoming is that the camera fitted at the instrument provides only a two–dimensional view and hence the dimension of depth is lost," he adds.

On the other hand, the camera used in robotic surgery has two lenses – giving a lifelike or 3–D picture.

Its other advantage is that the arm of the robot has a 360–degree movement – just like a human hand, while laparoscopic instrument’s arm has a unidirectional movement.

"Robotic surgery gives the best of both – open surgery in terms of 3–D view and laparoscopy in terms of smaller cuts," he said.

The only disadvantage of the surgery is its high cost, which is at least Rs.1 lakh (about 2,000 USD) more than a normal surgery.

The chest surgeries performed by robots are mainly for Myasthenia Gravis – a disease characterised by nervous and muscular weakness.

Usually these operations leave a deep scar on the chest of the patient – making it medically complicated as well as a stigma. In the robotic surgery, the long cut is replaced by three small holes which are barely 10 mm to 1 cm in size.

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