Gyno-botic marvels

HYDERABAD: As we get in touch with Dr Rooma Sinha, who is an honorary professor and chief gynaecologist, a laparoscopic and robotic surgeon at Apollo Hospitals in Hyderabad, she says that the first question people ask her while talking about robotic surgery is, ‘Is there a robot operating on the patient?’ “The answer is obviously, no,” she says. “It is a myth. It is a computer-enhanced surgery, a more advanced form of minimally-invasive surgery,” she explains.

Dr Sinha has expertise in performing minimally invasive gynaecological surgeries using laparoscopy and robotic technology. She specialises in non-descent vaginal hysterectomy, urogynaecology and pelvic reconstructive surgeries. In 10 years of her utilisation of robotic technology, she has successfully done 650 surgeries. Explaining the difference between laparoscopy and robotic surgery, she says, “Robotic-assisted surgery is actually an advanced form of minimally invasive surgery, an advanced form of keyhole surgery through which we can treat patients in a more effective manner. The main change from open surgery to minimally invasive surgery is that instead of making very big cuts in women’s abdomen, we can do the surgery with tiny incisions.”

What are the benefits of robotic-assisted surgery for patients and surgeons?  

“The women need not undergo major cuts up in their tummy and lie down at home for a few weeks and recover,” says Dr Sinha. “They have small hole surgeries where the pain is minimal and the need for blood transfusion is also reduced. The main aspect is that they hardly stay in the hospital for the night. In about three or four days, most of my patients are cooking their food at home and in one week or 10 days, they’re back in their office. This is the quick recovery that we are talking about,” she adds.Shedding light on what this technology has in store for the surgeons, Dr Sinha says, “With laparoscopy, we only have a 2D view. We are basically looking at a TV monitor and operating on the patient. But advanced robotic platforms like Da Vinci have given us a 3D vision. The precision and dexterity of this technology allow me to move some very fine instruments inside the patient just like my hand. There is no tremor and blood loss is less. These benefits help me do complex surgery in an efficient manner.”

Is it required for all surgeries?

“Not all problems may require this advanced technology as of now. However, any surgery that women need for their uterus, ovary or related organs can be done by robotic technology whether it is cancerous or non-cancerous,” says Dr Sinha. “For example, for patients having fibroids, a myomectomy (removal of fibroids) can be done with this technology. Patients having endometriosis, so removing excision of endometriosis or patients who are requiring a hysterectomy (removal of the uterus because of some disease), patients requiring removal of ovaries or patients having a lot of prolapse can also get treated by robotic surgery. At Apollo, we have a special care centre. All the patients with very complex problems reach out to us and we are able to help them without doing an open surgery,” she adds.

How to make technology accessible to all?

According to Dr Sinha, women, being at the centre of everything, be it the home, the society or the nation, need the best technology to heal when they are suffering from gynaecological issues. “It is for the industry, the governments and all other stakeholders to come together and make this technology accessible to all. What is in our hands is training more and more people to use this technology,” she says, adding that as part of this endeavour, she has formed a government-registered medical body, called the Association of Gynaecological Robotics Surgeons of India (AGRS). “The focus is mainly on training more and more gynaecologists. Right now, we use the Da Vinci Xi system by US-based Intuitive.  However, the government is trying to put in place some India-made systems also. Our job is to train as many people as possible,” she says.

Is this technology expensive?

“Right now, it is slightly expensive, as most of the technology that we are using is imported. There are some companies in India that are trying to build this kind of technology here as well. But it is true for any technology whether it is medicine or anything else. In general, it costs about 20 to 25% more than the cost of a regular surgery but with more availability, the cost will reduce,” Dr Sinha says. Assuring the citizens that robotic surgery is a perfectly standardised and safe method to undergo treatment, she emphasises that instead of keeping their health on a back burner, women should come forward and seek help as early as possible. Also, they must explore all options before saying yes to an open surgery. If possible, opt for the keyhole method, either using laparoscopy or robotics, as they need not suffer from large scars.

RAS for safe treatment, speedy recovery

Assuring the citizens that robotic surgery is a perfectly standardised and safe method to undergo treatment, Dr Sinha emphasises that instead of keeping their health on a back burner, women should come forward and seek help as early as possible.

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