Friday December 14, 2018

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

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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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Atal Bihari Vajpayee: A Peace Visionary and a Man Who Believed in India’s Destiny and was Ready To Fight For It

It was precisely this persona of Vajpayee -- one merged in Hindutva ideology yet seemingly not wholly willing to bow to it -- that won him admirers cutting across the political spectrum.

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Atal Bihari Vajpayee,
Atal Bihari Vajpayee, India's peace visionary. Image: Flickr

Atal Bihari Vajpayee was a man of moderation in a fraternity of jingoistic nationalists; a peace visionary in a region riven by religious animosity; and a man who believed in India’s destiny and was ready to fight for it.

Former Prime Minister Atal Bihari Vajpayee (93), who died on Thursday, will go down in history as a person who tried to end years of hostility with Pakistan and put development on the front burner of the country’s political agenda. He was also the first non-Congress Prime Minister to complete a full five-year term.

Even though he lived the last 13 years of his life in virtual isolation, dogged by debilitating illnesses and bedridden, he has left an enduring legacy for the nation and the region where he was much loved and respected across the political spectrum and national boundaries, including in Pakistan.

Vajpayee, former Indian Prime Minister
Vajpayee stunned the world by making India a declared nuclear state. Image: Wikimedia Commons

In the tumultuous period he presided over the destiny of the world’s largest democracy, Vajpayee stunned the world by making India a declared nuclear state and then almost went to war with Pakistan before making peace with it in the most dramatic fashion.
In the process, his popularity came to match that of Indira Gandhi, a woman he admired for her guts even as he hated her politics.

He also became the best-known national leader after Indira Gandhi and her father Jawaharlal Nehru.

After despairing for years that he would never become Prime Minister and was destined to remain an opposition leader all his life, he achieved his goal, but only for 13 days, from May 16-28, 1996, after his deputy, L.K. Advani, chose not to contest elections that year.
His second term came on March 19, 1998, and lasted 13 months, a period during which India stunned the world by undertaking a series of nuclear tests that invited global reproach.

Although his tenure again proved short-lived, his and his government’s enhanced stature following the world-defying blasts enabled him to return as Prime Minister for the third time on October 13, 1999, a tenure that lasted a full five-year term.

When finally he stepped down in May 2004, after an election that he was given to believe he would win, it marked the end of a long and eventful political career spanning six decades.

Vajpayee had gone into these elections riding a personality cult that projected him as a man who had brought glory to the nation in unprecedented ways. The BJP’s election strategy rested on seeking a renewed mandate over three broad pillars of achievement that the government claimed — political stability in spite of the pulls and pressures of running a multi-party coalition; a “shining” economy that saw a dizzying 10.4 percent growth in the last quarter of the previous year; and peace with Pakistan that changed the way the two countries looked at each other for over 50 years.

The results of the elections could not have come as a greater shock to a man who was hailed for his achievements and who was named by Time magazine as one of the 100 influential men of the decade.

Success didn’t come easily to the charismatic politician, who was born on Christmas Day in 1924 in Gwalior, Madhya Pradesh, into a family of moderate means. His father was a school teacher and Vajpayee would later recall his early brush with poverty.

He did his Masters in Political Science, studying at the Victoria College in Gwalior and at the DAV College in Kanpur, Uttar Pradesh, where he first contested, and lost, elections. He began his professional career as a journalist, working with Rashtradharma, a Hindi monthly, Panchjanya, a Hindi weekly, and two Hindi dailies, Swadesh and Veer Arjun. By then he had firmly embraced the ideals of the Hindu nationalist Rashtriya Swayamsewak Sangh (RSS).
But even as he struggled to win electoral battles, his command over Hindi, the lingua franca of the North Indian masses, his conciliatory politics and his riveting oratory brought him into public limelight.

Also read: For Modi, Road To 2019 Will Be Steeper

His first entry into Parliament was in 1962 through the Rajya Sabha, the upper house. It was only in 1971 that he won a Lok Sabha election. He was elected to the lower house seven times and to the Rajya Sabha twice.

Vajpayee
Vajpayee spent months in prison when Indira Gandhi imposed Emergency rule in June 1975. Image: Wikimedia Commons

Vajpayee spent months in prison when Indira Gandhi imposed Emergency rule in June 1975 and put her political opponents in jail. When the Janata Party took office in 1977, dethroning the Congress for the first time, he became the foreign minister.

The lowest point in his career came when he lost the 1984 Lok Sabha polls, that too from his birthplace Gwalior, after Rajiv Gandhi won an overwhelming majority following his mother Indira Gandhi’s assassination. And the BJP he led ended up with just two seats in
the 545-member Lok Sabha, in what looked like the end of the road for the right-wing party.

In no time, Vajpayee was replaced and “eclipsed” by his long-time friend L.K. Advani.
Although they were the best of friends publicly, Vajpayee never fully agreed with Advani’s and the assorted Hindu nationalist groups’ strident advocacy of Hindutva, an ideology ranged against the idea of secular India.

Often described as the right man in the wrong party, there were also those who belittled him as a moderate “mask” to a hardline Hindu nationalist ideology. Often he found his convictions and value systems at odds with the party, but the bachelor-politician never went against it.

It was precisely this persona of Vajpayee — one merged in Hindutva ideology yet seemingly not wholly willing to bow to it — that won him admirers cutting across the political spectrum. It was this trait that made him the Prime Minister when the BJP’s allies concluded they needed a moderate to steer a hardliner, pro-Hindu party.

He brought into governance measures that created for India a distinct international status on the diplomatic and economic fronts. In his third prime ministerial stint, Vajpayee launched a widely acclaimed diplomatic initiative by starting a bus service between New Delhi and Pakistan’s Lahore city.

Its inaugural run in February 1999 carried Vajpayee and was welcomed on the border by his Pakistan counterpart Nawaz Sharif. It was suspended only after the 2001 terror attack on the Indian Parliament that nearly led to a war between the two nuclear-armed neighbours.

The freeze between the two countries, including an eyeball-to-eyeball confrontation on the border for nearly a year, was finally cracked in the spring of 2003 when Vajpayee, while in Kashmir, extended a “hand of friendship” to Pakistan. That led to the historic summit in January 2004 with then President Pervez Musharraf in Islamabad — a remarkable U-turn after the failed summit in Agra of 2001. Despite the two men being so far apart in every way, Musharraf developed a strong liking for the Indian leader.

His unfinished task, one that he would probably rue, would be the peace process with Pakistan that he had vowed to pursue to its logical conclusion and a resolution of the Kashmir dispute.

He was not known as “Atal-Ji”, a name that translates into firmness, for nothing. He could go against the grain of his party if he saw it deviate from its path. When Hindu hardliners celebrated the destruction of the 16th century Babri Mosque at Ayodhya, he was full of personal remorse for the apocalyptic action and called it — in a landmark interview to IANS — the “worst miscalculation” and a “misadventure”. He even despaired that “moderates have no place — who is going to listen to the voice of sanity?”

In his full five-year term, he successively carried forward India’s economic reforms programme with initiatives to improve infrastructure, including flagging off a massive national highway project that has become associated with his vision, went for massive privatisation of unviable state undertakings despite opposition from even within his own party.

While his personal image remained unsullied despite his long innings in the murky politics of this country, his judgment was found wanting when his government was rocked by an arms bribery scandal that sought to expose alleged payoffs to some senior members of his cabinet. His failure to speak up when members of his party and its sister organisations, who are accused of killing more than 1,000 Muslims in Gujarat, was questioned by the liberal fraternity who wondered aloud about his secular proclamations. He wanted then Chief Minister — now Prime Minister, Narendra Modi — to take responsibility for the riots and quit but was prevailed upon by others not to press his decision.

A day before his party lost power, Vajpayee was quoted as saying in a television interview that if and when he stepped down he would like to devote his time to writing and poetry. But fate ruled otherwise. The man who once rued that “I have waited too long to be Prime Minister” found his last days in a world far removed from the adulation and attention — though across the nation people prayed for his well-being — surrounded only by care-givers and close family whom he even failed to recognize. (IANS)