- Welcome to Anil Mandhani
- Call for Appointment +918920721799
It’s Not Robotic Surgery, It’s Robot-Assisted Surgery
Recently, a patient refused robot-assisted surgery for prostate gland removal due to prostate cancer. His concern was not about affordability, which is often a deciding factor, but rather a fundamental misunderstanding—he believed a robot would perform the surgery, and he wasn’t willing to entrust his life to a machine. This is a common misconception.
In reality, robot-assisted surgery is performed by a highly skilled surgeon who controls robotic arms equipped with surgical instruments. The robot does not act independently; it serves as an advanced tool that enhances precision. This is why the correct term is robot-assisted surgery, not robotic surgery.
The Evolution of Surgery
Surgical advancements have shifted from the old notion that “big surgeons make big incisions” to a more refined approach where skilled surgeons aim for smaller, minimally invasive incisions. Laparoscopic surgery, which involves strategically placed small incisions, follows the same surgical principles as open surgery while minimizing trauma to the patient. The goal is not just cosmetic improvement but faster recovery, reduced pain, and better clinical outcomes.
The da Vinci Surgical System allows surgeons to perform complex procedures through small incisions with exceptional precision. Patients benefit from less pain, minimal blood loss, shorter recovery times, and quicker return to daily activities.
Advantages and Limitations
While laparoscopy revolutionized surgery, it has certain limitations such as lack of 3D vision and restricted movement of instruments. Laparoscopic tools are rigid, lacking the flexibility of a human hand. Robot-assisted surgery overcomes these limitations by providing high-definition 3D vision and wristed instruments that mimic the movement of a surgeon’s hands, allowing for greater precision in complex surgeries.
This technology is particularly beneficial in deep-seated organs like the prostate gland, as well as in urology, cardiac, thoracic, gynecology, ENT, colorectal, pediatric, and general surgeries.
Robot-Assisted Surgery in India
India’s first robotic radical prostatectomy was performed at AIIMS, New Delhi, in July 2006. Since then, there have been over 80 installations across India, including 11 in the NCR region. Today, most high-end urological procedures utilize robot assistance. Common robotic procedures include:
- Radical prostatectomy for prostate cancer
- Radical cystectomy for bladder cancer
- Partial nephrectomy for kidney cancer
- Reconstructive surgeries for kidney and ureter defects
- Surgeries for obese patients, where maneuverability is critical
Understanding the Robotic Surgical System
The latest system in use is the da Vinci Xi model, developed by Intuitive Surgical, California, USA. It consists of four key components:
- Surgeon Console – Provides a magnified, high-resolution 3D view of the surgical site
- Patient-Side Cart – Houses robotic arms that hold the surgical instruments
- EndoWrist Instruments – Mimic the movements of a human hand for enhanced precision
- Vision System – Features a high-resolution 3D endoscope with real-time image processing
The Intuitive Masters technology eliminates hand tremors and enhances precision. The system also includes features such as automatic temperature control for the endoscope to prevent fogging and foot pedal controls for seamless view switching.
The Future of Robot-Assisted Surgery
The da Vinci Surgical System is a valuable advancement, providing an alternative to traditional open surgery and laparoscopy. However, it is important to acknowledge that while the robot enhances precision, it does not eliminate potential surgical risks related to anesthesia or equipment failures.
One limitation is the lack of tactile feedback, meaning surgeons cannot physically feel the tissue. However, 3D magnification compensates for this, along with the surgeon’s expertise.
As technology progresses, a key question arises: Should India invest heavily in expensive robotic systems when basic healthcare is still a challenge for many? The answer lies in innovation. Just as India has made strides in space technology, we can work toward developing indigenous robotic surgical systems, making high-quality healthcare accessible to a broader population.
As William Gibson, the famous science fiction writer, once said: “The future is already here—it’s just not very evenly distributed.” The same applies to robot-assisted surgery. It is a transformative step forward, and efforts should be made to make this technology more widely available.
