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Surgical bots to be ubiquitous in Indian hosps


By NewsGram Staff-Writer


Chennai: Days are not far off when surgical robots will become a normal feature in hospitals for procedures like MRI scans, a senior official of Intuitive Surgical Inc. said on Sunday.

The US-based Intuitive Surgical makes surgical robots that enable minimally invasive surgeries with its da Vinci surgical systems. The primary surgical domains are urology, gynaecology, general surgery and cardiothoracic.

Jeroen MM van Heesewijk, senior vice president, Asia Pacific and Global Distribution said,”In India, we are infants in the technology adoption curve. Today a hospital without a magnetic resonance imaging (MRI) scan machine is considered as a clinic.”

“Offering robotic surgeries will also give a boost to the countries medical tourism sector,” Mahendra Bhandari, CEO, Vattikuti Foundation, added while talking over the issue. Both were at Kochi to attend a two-day seminar on robotic surgery organised by Vattikuti Foundation.

According to van Heesewijk, India, China and Brazil, are important markets for Intuitive Surgical procedures. A total of 26 da Vinci systems are in operation in India at various hospitals. In India, Vattikuti Technologies is sole distributor and van Heesewijk said the company is not planning to go direct-selling directly to hospitals in India.

Van Heesewijk welcomed the tie-up between Google Inc. and Johnson & Johnson to work in the field of surgical robotics. According to him, the fact that two global players with deep pockets getting into robotics is a clear indication that robotic surgery segment will get a big boost.

Meanwhile, the Vattikuti Foundation is planning to increase the number of surgeons trained on robotic surgical systems to 300. Bhandari informed, “Presently, there are 147 surgeons trained in robotic surgeries in India. They do 300-400 robotic surgeries. Our target is to increase the surgeons trained in robotic surgeries to 300 by 2020.” According to him, when the foundation was started in 2009-10 there were only five or six surgeons trained to carry out robotic surgeries.

Queried whether the foundation would train surgeons only on da Vinci systems distributed in India, he said: “Intuitive Surgical is the market leader.” Bhandari said once a surgeon is trained, training him in other systems is not a big issue.”

On the advantages of robotic surgeries, he said the incision will be small and the loss of blood will be very minimal. He said the recovery of the patient is faster and the post-operative pain will also be less.

According to Bhandari, robotic procedures in India that cover a wide spectrum of procedures -cardiac, urology, general surgery, thoracic, gynaecology, head and neck, vascular and paediatrics – are expected to cross the 6,000 procedures mark in 2015.

With Inputs from IANS

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Here is How Robotic surgery can counter Gynae problems in a better manner!

A woman (representational image), Pixabay

New Delhi March 7, 2017: At a time when gynaecological issues are on the rise, robotic surgery done through a minimally invasive method can offer women a better outcome to various problems — from fibroids to cancer — than traditional methods, experts suggest.

Any kind of open surgery gives rise to many post-operative complications like pain, blood loss and, often, due to poor visualisation, the outcome is not as optimal as desired. But when treated with robotics, “it allows for better control and reduces complications”.

Robotic surgery does away with the need to cut and open-up a patient’s body.

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“Robotic surgery offers better instruments, visuals, hence less blood-loss and tissue damage. Moreover, it enables the surgeon to perform complicated surgeries with ease,” Anupama Shyam, Robotic Surgeon and Professor at Kochi’s Amrita Institute of Medical Sciences, told IANS in an email interview.

With the four-armed “Da Vinci Surgical Robot” developed by the US-based Intuitive Surgical, tiny instruments are sent in and controlled by an accomplished surgeon sitting at a nearby console.

The surgeon has a magnified, high-definition, three-dimensional (3-D) view as if sitting inside the patient’s body and, with a joy stick, manipulates tiny surgical instruments that enjoy flexibility better than human hands.

“Robotic surgery is mostly used to perform surgery for endometrial and cervical cancer, which includes complex procedures like radical hysterectomy (removal of cancerous uterus, cervix) and pelvic and para-aortic lymphadenectomy,” explained Sudhir Rawal, Director (Surgical Oncology Chief) at the Rajiv Gandhi Cancer Institute & Research Centre, New Delhi.

The surgery is best for getting under soft tissue to reach organs that otherwise require opening up, involve long and painful recovery periods and leave behind ugly scars.

It can be used in both benign and malignant gynaecological conditions such as for patients with cancers of the cervix and vagina, as well as provides better patient outcomes. With minimal blood loss, patients recover quicker and get home faster.

“For most robotic surgery procedures, I recommend early morning admission of patients and surgery in the forenoon so that they are able to get home by evening,” said Rooma Sinha, Gynaecologist, Laparoscopic and Robotic Surgeon, Urogynaecologist, at Apollo Health City in Hyderabad.

In cases of fibroids — non-cancerous growths in the uterus that can develop during a woman’s childbearing years — scarring is a major issue. However, robotic surgery does away with the ugly scars.

Besides, any pelvic surgery requiring specific dissection and suturing of organs is best done with use of robotic surgery.

Further, robotic surgery is also advisable for elderly gynaecological cancer patients.

“Robotic surgeries are most useful in gynaecological malignancies where laparoscopy is hindered by the heterogeneity of gynaecological cancer patients who are often elderly, obese and have multiple co-morbidities,” Rawal said.

Robotic Surgery has actually been around since the 2000s, and offers immense possibilities in thoracic, urology, gynaecological, colorectal, paediatric and general surgical disciplines.

According to a 2016 report by the US-based non-profit organisation Vattikuti Foundation, there are 190 robotic surgeons in India across 30 hospitals.

Of these, 12 are in north India (including AIIMS, Apollo, Max, Rajiv Gandhi Cancer Institute, Sir Ganga Ram Hospital, Fortis, Medanta); nine in western India (Jaslok Hospital, Kokilaben Dhirubhai Ambani Hospital, Sir HN Reliance Foundation Hospital, Tata Memorial Hospital); eight in southern India (Apollo Hospital, Chennai and Hyderabad, Krishna Institute of Medical Sciences, Hyderabad, Amrita Institute of Medical Sciences, Kochi, and Aster Medicity, Kochi); and one in Kolkata (Apollo Gleneagles Hospital).

In 2015, the 190 robotic surgeons in India performed over 4,000 procedures in the areas of urology, gynaecology, thoracic, paediatric, general surgery, head and neck and bariatric (weight-loss) surgeries.

The foundation aims to expand the pool of accomplished robotic surgeons to 500 by 2020 and over 100 hospitals.

“Robotic surgery is here to stay in India and it is up to the government to lead the way and make its maximum use,” the experts noted. (IANS)

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US-based non-profit Vattikuti Foundation awards Fellowships to 7 Indian Surgeons

Robotic surgery scores over conventional surgery, as it minimises blood loss, drastically reduces the post-operative recovery time

Robotic Surgery. Representational image. Wikimedia
  • In a bid to grow a pool of robotic surgeons in India, US-based non-profit Vattikuti Foundation has awarded a year-long fellowship to seven Indian surgeons
  • The seven selected Vattikuti fellows will begin their training in robotic surgery by working with their mentors at various renowned medical institutes across the country
  • Robotic surgery scores over conventional surgery, as it minimises blood loss, drastically reduces the post-operative recovery time

October 18, 2016: In a bid to grow a pool of robotic surgeons in India, US-based non-profit Vattikuti Foundation has awarded a year-long fellowship to seven Indian surgeons to specialise in robotic surgery in the areas of urology, gynaecology and head and neck surgery, the company said on Tuesday.

During the fellowships, the surgeons would be trained in simulation-based dry laboratory for bedside patient assistance, patient positioning and port placement skills as well as in porcine laboratories (pig labs) for practical training.

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“At the end of this rigorous training process, we expect these bright surgeons with impeccable qualifications to become accomplished robotic surgeons capable of handling procedures independently,” said Mahendra Bhandari, CEO at Vattikuti Foundation in Detroit, US.

Dr Mahendra Bhandari, CEO at Vattikuti Foundation in Detroit, US. Wikimedia commons

The seven selected Vattikuti fellows will begin their training in robotic surgery by working with their mentors at New Delhi’s Medanta Vattikuti Institute, Escorts Fortis Institute, and Rajiv Gandhi Cancer Institute, Apollo Hospitals – Chennai, Amrita Institute of Medical Sciences – Kochi, and Manipal Hospital – Bengaluru starting this month.

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The Fellowships are part of a commitment by Vattikuti Foundation, a non-profit organisation focused on promoting Robotic Surgery in the India, Europe and the US, to grow the number of trained robotic surgeons in India to 500 by 2020 through the award of 100 fellowships in five years.

Robotic surgery scores over conventional surgery, as it minimises blood loss, drastically reduces the post-operative recovery time, and brings precision in executing the procedure, thereby potentially saving healthy tissue from damage.

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With four arms, it can reach organs and areas where human fingers cannot. The three-dimensional view, that can be magnified multifold, helps the surgeons achieve precision that prevents collateral damage to healthy tissue. (IANS)

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Doctor-Diagnostic Centre nexus: Plaguing health care sector since ages

Unholy prescriptions

By Meghna Nair

“Medicine is a profession where one can play God.” That is probably the most clichéd statement one can come across.

In time of health crisis, doctor is synonymous with God to us. But what happens when the doctors have other plans?

A huge doctor-diagnostics centre nexus has been exposed in the North-Eastern state of Assam. According to a report published by Assam Tribunal, many doctors prescribed unnecessary tests to the patients in exchange of huge commissions.

But, this isn’t the first time it is happening. In the past few years, several cases have come to the limelight wherein people have been prescribed expensive tests for no substantial reason.

A very grave instance was reported in Assam wherein a couple was forced to sell their newborn because they couldn’t handle the medical expenses owing to the caesarian section the mother underwent. The height of irony is the fact that the incident happened in a government hospital in the capital city of Dispur.

The incident, although occurred in 2012, had brought up the issue of various kinds of nexuses existing between doctors and pharmaceutical companies, diagnostic centers etc.

According to the same report, doctors demand 30-50 per cent commission from the diagnostic centers by cash every month on MRI and CT scans.

Everyone knows that the field of medicine is well paying and that is one of the many reasons why it is one of the most sought after professions in India. Why then, are the doctors getting greedy and exploiting the common man?

“It is true that doctors get paid well, but there is a huge disparity between how much a doctor practicing in the city earns, as compared to his rural counterpart. The difference is not small. For example, if in cities like Delhi, a doctor is earning Rs. 60,000 a month, in rural areas the earnings would amount to as low as one third of this, i.e. roughly 20,000 rupees a month. That is a big disadvantage,” says Dr. Abhishek Shankar, who is currently practicing in AIIMS, New Delhi.

Be it Delhi or Andhra Pradesh, these nexuses are omnipresent. A nexus of an Ahmedabad based pharmaceutical company and 40 doctors from Telangana was exposed in 2013. The doctors were pushing the sales of certain drugs in exchange of expensive gifts from the company.

A sting operation conducted by a private media outlet in 2014 revealed shocking details about the issue.

As reported by the media, the doctors struck deals with the pharmaceutical companies and provided monthly stats and details about the patients they tended to and took bribes ranging in lakhs.

“There are many frauds in this profession. Many people with fake degrees open up clinics and prescribe useless tests to the unassuming patients to rake in the commission. They are maligning the profession and are responsible for the distrust people have,” says Dr. Rakesh Gupta, a practicing Orthopedician.

With power comes responsibility

Are doctors alone responsible for this problem?

It is true that doctors do have a share in this, but the blame rests equally on the masses.

With changing times and the information available on the internet, there exists a general distrust among people towards doctors.

But, as they say, “half knowledge is a dangerous thing” and that is exactly the problem.

A headache becomes a migraine, a migraine becomes a cluster headache, and there is really no limit to the ever escalating presumptions of people. Then such a person goes to the doctor and he gets treated for simply a headache and not a cluster headache, the patient starts doubting the doctor’s competence because he has already assumed the worst.

“These days the financial status of the middle class has improved and people now have less patience and increased paying capacity. They can afford to pay the consultation fees and the cost of the treatments.

When the middle-class man comes to government establishments like AIIMS, he has to wait for his turn among the working class people. This requires patience. Now, the thought process has become such that if at all they can escape the wait, and get things done, they’d not really mind paying a few bucks. That is where the problem starts,” says Dr. Abhishek Shankar.

But how much is too much? How can the patient be more aware?

Diagnostics is a crucial branch of medicine. Today, the progress of this very branch has resulted in the possibility of curing myriad diseases which were a huge threat to mankind in previous days.

The advancement of diagnostics has been a boon. In government hospitals, the number of patients is huge. But the job of a doctor becomes easier with diagnostic tools.

Earlier on, the doctor used to talk to the patient, take detailed history, use his/her clinical acumen and then if needed, uses diagnostic tools.

But now, the number of patients has increased manifold and government hospitals do not let you devote too much time on one patient when you know there are 99 others waiting outside for their turn. This is where diagnostic tools come in handy.

“Diagnostics is very important and it helps you be efficient and accurate. With the help of these tools, diagnosing is easier and the room for error is significantly reduced. But then, some people misuse these facilities and scandals arise,” Dr. Shankar says

But what should a patient do in case he/she isn’t satisfied with the doctor’s advice?

“When in doubt, go for a second opinion! And preferably go to a government run institution if you are afraid that the doctor is prescribing unnecessary tests,” Dr. Gupta adds.

Each illness is different and different diseases also affect different people differently. One can only keep his/her eyes and ears open and try to approach government hospitals to avoid being victims of commercialization.