We have come a long way since anesthesia and antisepsis were introduced in modern surgery. With safe anesthesia and appropriate antibiotics and sterile techniques to prevent surgical site infections, the sky was the limit in treating diseases surgically. The next step was to improve the quality of life of these ever-busy women with quick recovery and less pain who were undergoing gynaecological surgeries. Introduction of keyhole surgery (laparoscopic surgery) aimed to achieve this goal. It did succeed, however, is not universally offered to all women who needed gynaecological surgery. The question is why laparoscopic hysterectomy or myomectomy has not become a standard operative modality as laparoscopic cholecystectomy has? This is so because these are more complex surgeries and not always possible with straight stick laparoscopic instruments.
Robot-assisted surgery is the next logical step in laparoscopic surgery. But unlike laparoscopic surgery, precise movement of the instruments helps to perform more complex procedures reaching the odd and difficult areas of the body thus enabling them to do precise and complete surgery.
- Stereoscopic 3D 10 times magnified vision- which is focused and provided the excellent vision of the area the surgeon is operating Near control of Surgical field where the surgeon controls the camera movement giving her a steady vision of the operating field. Also, she is able to use three instruments to operate giving her flexibility.
- Intuitive movements are movements that make the instruments move in the same direction as the hands during surgery as compared to counter-intuitive movements in conventional laparoscopy
- THE WRIST-is the Missing Link! No surgical instrument till date gives a human wrist like movements while doing surgery. Robotic instruments help one perform the surgery just like the movements of human hand during an open surgery but without a big scar providing utmost precision in surgery and quick recovery.
- Fertility enhancing surgeries – myomectomy and endometriosis
- Cancer of uterus
- Complex and difficult hysterectomy
- Prolapse surgery especially ones that develop after hysterectomy or urinary fistula
This new category of minimally invasive surgery combines the best of open and laparoscopic surgery. With the assistance of Robotic ARMS (controlled by the surgeon of course!), surgeons can perform surgeries through small incisions with unmatched precision and control.
- Less Scarring– Due to precise movement, tissue trauma is less.
- Minimal Blood Loss– With better dissection in the right planes and the ability to suture more quickly, there is significantly less blood loss.
- Less post-operative pain– Experience faster healing with less pain.
- Faster recovery– Patients are able to resume their normal activities within a few days and often are fit to travel in a week. Unlike 6 weeks needed to recover after open surgery. Many patients go home on the same day as well.
- Excellent suturing– Precise instrumentation with wrists like movements and 3D visualization enables the surgeon to suture the uterus appropriately.
Contrary to the myth regarding robotic surgery, it is the surgeon and her surgical skill that determines the outcome of the surgery and not the ROBOT as it cannot do anything on its own. We are one of the pioneer centres in Gynecological robotic surgery with the maximum number of Robot-assisted Myomectomy performed by a single surgeon in the whole country. We have many success stories of women conceiving and delivering after robotic-assisted myomectomy at Apollo Hospital, Hyderabad India.
Dr. Roma Sinha
Dr. Anuradha Panda