When 35-year-old Ramesh (name changed to protect privacy) from Chennai received the diagnosis for his kidney symptoms, he couldn’t believe it. Before he walked into Apollo Hospitals at OMR in Chennai, he didn’t think he would have to worry about the C-word. But there it was, cancer of the kidney.
The only thing that kept him from instant panic was his doctor’s assurance that his condition was treatable with surgery, and that much of his kidney could still be saved.
“In earlier days, we would have just had to remove his entire kidney,” explains Ramesh’s doctor and consultant urologist and renal transplant surgeon, Dr Mohankumar. But now, thanks to massive advances in robotic technology, he has the technical support and precision to perform much more difficult operations that can assure patients like Ramesh a higher quality of life.
“Nowadays, what we commonly do is a partial nephrectomy, to only remove the portion of the kidney that has the malignancy. If we do this with laparoscopic surgery, suturing is very difficult. This is because such kidney surgery is a race against time. What we have to do is to clamp the artery and the vein and quickly finish the surgery within 15-20 minutes. Otherwise there will be permanent damage to the kidney,” explains Dr Mohankumar.
The benefits of machine-guided precision
This is where robotic surgery comes into the picture. Unlike conventional laparoscopy, robotic surgical systems allow surgeons to achieve high levels of precision, up to a few millimetres, and that allows doctors to carefully target cancerous tissue while saving as much healthy tissue as possible. “This means that surgical outcomes are much better, and the chances of error are much lower,” explains Dr Mohankumar.
While laparoscopic surgeries also do provide for minimal invasive procedures, he adds, these tools do not have the functional range of robotic systems. “With laparoscopic tools, the movement is restricted and you cannot perform all the movements that the human hand can. The surgical robot, however, can perform all those 360-degree movements and with much more precision, and finesse.”
This means that with just a few keyhole-sized incisions, doctors guiding the surgical robot can perform as delicate or even more delicate actions as if they were physically operating in the room. What’s more, the surgical robot also comes equipped high-magnification cameras that give the surgeon a detailed view of the surgical site that they could not get with their own eyes.
Reduced damage, better recovery
Just as with kidney surgery, robotic surgery offers distinct advantages in the treatment of prostate and bladder cancers too.
“In prostate cancer, the advantage is that there is a cure for every stage. Surgery works especially well for Stage 1 and Stage 2 cancers,” explains Dr Mohan. However, open prostate surgeries come with added complications. “With open surgery, there is the risk of incontinence or urine leakage.” Nerve damage during surgery can also result in erectile dysfunction. The reconstruction is also extremely difficult and less precise in open surgery
“But this is completely changed with the advent of robotic surgery. Now surgeries are faster, more precise and have a much quicker recovery rate,” asserts Dr Mohan. “Incontinence rates are significantly lower, while the cancer removal rate and margin negativity has increased. We are able to provide much more functional improvement to the patient.”
Similarly, with bladder cancer, one of the most difficult parts of the surgery is reconstruction of the new bladder after removing the cancerous bladder. Again, the heightened precision of robotic surgery allows doctors to provide much safer, faster surgical interventions.
No limits of geography
One of the most exciting results of the development of robotic surgery, says Dr Mohan, is the possibility of doctors operating on a patient from across the world.
“In the west, we’re already hearing of trans-Atlantic surgeries, where the patient and the doctor are on different continents. We have not yet reached that stage of connectivity in India. But when this becomes possible, the expertise of a great surgeon in a particular speciality could become available to patients everywhere,” he points out.
This article was created by TNM Brand Studio in association with Apollo Hospitals.