When one thinks of an operating room, the general image one carries is that of a bunch of surgeons, several nurses, and countless instruments performing a surgery. However, with the latest advent of robotic surgery trend, the need of so many surgeons is diminishing. After all, when you have automated surgical robots working as per the instructions of surgeons who are sitting at a computer console, life seems much easier. And the good news doesn’t end here; robotic surgery has many advantages too.Today, Dr. Sudhir Prem Srivastava MD, who is currently practicing cardiothoracic surgery and general surgery in Atlanta, Georgia and Chicago, Illinois helps us understand this trend of robotic surgery in India. 

Here are the excerpts from the interview. 

Mansi Kohli: How is robotic surgery performed?

Dr. Srivastava: Robotic Surgery is the most advanced Minimally Invasive Surgery performed through small (finger size) incisions or operating ports resulting in potentially shorter recovery times, fewer complications, reduced hospitalization costs and reduced trauma to patients. 

Mansi Kohli: What are the risks involved in this procedure?

Dr. Srivastava: Though similar risks are involved in the robotic surgery and traditional method of surgery, some complications in certain surgeries are lesser or can completely be avoided. To take an example, impotence and incontinence are the most common side effects of the radical prostatectomy (procedure performed to remove prostate cancer) however; if the procedure is performed with robotic assistance this side effect is completely eliminated. If we take the example of cardiac surgery, in the 1300 robotic cardiothoracic cases performed by Dr. Sudhir Srivastava, the mortality rate has been 0.3% compared to 2%-3% in case of conventional methods of performing cardiac surgery.

Mansi Kohli: What about post and pre surgery care?

Dr. Srivastava: The pre surgery care is the same as traditional surgery. A patient should not have any food or fluid before 8 hours of the surgery. The patient is taken to a recovery room after the procedure. The patient has to stay in the hospital for just 2-3 days unlike 5-7 days in case of traditional surgery. There is minimal rehabilitation and one can resume normal activities in 7-10 days. The patient is not bed ridden for months.

Mansi Kohli: What are the advantages of robotic surgery?

Dr. Srivastava: There are multifold advantages of robotic surgery. They are: 

• Faster recovery and quick return to daily routine 
• Less blood loss and less risk of infection
• Lesser pain and trauma 
• Less blood loss and infection
• Increased range of motion 
• Improved dexterity
• Enhanced Visualisation
• Better access enabling the surgeon to perform complex procedures

Mansi Kohli: What kind of surgeries can be performed in robotic surgeries?

Dr. Srivastava: Being a versatile system, Robotic Surgery can be performed in cardiac, thoracic, urology, gynaecology, general, head & neck surgeries and orthopaedics. 

Mansi Kohli: How does robotic surgery work?

Dr. Srivastava: The surgery is done by a surgeon using a robotic surgical system called Da Vinci, which enables surgeons to be a more precise, advancing their technique and enhancing their capabilities in performing complex minimally invasive surgery. Robotic Surgery utilizes the most advanced technology allowing surgeons to perform complex surgical procedures that may not be feasible through Laparoscopic/Endoscopic procedures. 

With Da Vinci Surgical System, surgeon sitting at a console a few feet from the patient, this system translates that surgeon’s hand movements into corresponding micro-movements of instruments inside the patient’s body. The Da Vinci System also provides better visualization, dexterity, precision and control than open surgery, while enabling the surgeon to perform procedures through tiny, 1-2 cm incisions. 

Mansi Kohli: How old is this concept as far as India's medical advancements are concerned and what according to you is the future of it on Indian soil?

Dr. Srivastava: The first ever robotic surgery performed in India was in the year 2002 by Dr. Sudhir Srivastava at Escorts, New Delhi. Since then the number of robots in India has increased from 1 to 14. 

The future of Robotic Surgery in India seems quite promising. Patients are becoming more informed and leaning towards minimally invasive options across all specialty service lines. Slow adoption in India has primarily been due to lack of professional talent. Once we create a pool of talented Robotic Surgeons in India, it would become the preferred choice of patients, whom after becoming aware of the benefits offered, are demanding a more minimally invasive alternative.

Dr. Sudhir Prem Srivastava has spent his entire career outside of India perfecting the craft of Cardiothoracic Surgery. Dr. Srivastava is known to have trained many of the best robotic heart surgeons in the world.  It was at Alliance Hospital where Dr. Srivastava achieved many ‘world’s first’ operations in performing a double and triple bypasses on a beating heart in a totally closed chest setting.  He became well known for being able to do very complex cardiac surgical procedures utilizing the da Vinci robot and is often referred to as Dr. Robot!

*Image courtesy: © Thinkstock photos/ Getty Images