With the use of newer technologies that are evolving one can access minute body parts that would otherwise be inaccessible to a surgeon. Robotic assisted surgery (RAS) is one such technology that is gaining popularity in the Heathcare sector. Medical institutions are investing in it heavily while doctors and clinicians are getting trained to become better skilled at using robotics. This is because robotics does not just help surgical staff access certain parts of the body more easily, but they also help in reducing error. The RAS also reduces the invasiveness, which comes with conventional surgical procedures, thereby ensuring faster recovery due to smaller incisions and lesser blood loss. Other benefits include lower chances of postoperative infection, less pain, great cosmetic results and better post-operative immune function. The cost benefit is therefore proportional.
One of the key advantages of RAS is that the need for the doctor to be physically present beside the patient is reduced. These surgeries can be performed with the doctor sitting thousands of km away. The technology also reduces things like errors due to finger tremors while significantly improving dexterity and ergonomics. The robotics arms and instruments can reach areas which are difficult for humans to access due to the physical limitations of the human arm, wrist and hands. Robotic arms have seven degrees of freedom, and provide the surgeon with 360 degree access while sitting comfortably on the console. In the case of nerve and brain surgeries, the use of robotics allows surgeons to get to the microscopic areas using various levels of magnification. Another benefit of RAS is that it allows the surgeon more time to perform surgeries, as the doctor wouldn’t have to physically twist and turn to reach the nooks and crannies during the surgery. This also lessens fatigue of the surgeon.
Robotics surgeries are increasingly being used to cure snoring and obstructive sleep apnea, thyroid and parathyroid issues, neck dissections, tumours of oral cavity, oropharynx and larynx, recurrent nasopharyngeal cancer as well as hemangiomas, lingual thyroid, floppy epiglottis, elongated styloid processes (eagle’s syndrome) and cysts in the lower throat. To treat cancerous or benign tumours of the oropharynx and supraglottis, transoral robotic surgery is increasingly being preferred. This type of robotic surgery eliminates the need for cutting the jaw, inserting feeding tubes, blood transfusions or tracheostomies which happens in traditional surgeries. This helps to improve quality of life for patients post surgical operation.
Then there is the reduced cost. While the expertise, as is the case for most cutting edge technologies, can be expensive, robotic assisted surgery significantly cuts down other costs. It can be used to avoid chemotherapy in the case of some cancers, and even in treating thyroid and sleep apnea issues. The time taken for recovery after surgery is also minimal. Even the time taken to prepare the patient, set up the equipment and to perform the actual surgery comes down significantly. With reduced hospital stays and costs, health insurance providers also encourage such procedures. People have started to actively opt for this kind of procedure. One other advantage is that junior doctors and other staff can watch the surgery on the additional 2-D screen display, which helps to supplement their learning curve.
The writer is Dr Kalpana Nagpal Senior Consultant – ENT at Indraprastha Apollo Hospitals, Delhi