PINAKI MAJUMDAR
Jamshedpur, April 2: Medicine has come a long since anesthesia and antisepsis were introduced in modern surgery.
With safe anesthesia and appropriate antibiotics and sterile techniques to prevent surgical site infections, the sky was the limit in treating diseases surgically.
The next step was to improve the quality of life of these ever-busy women with quick recovery and less pain who were undergoing gynecological surgeries.
Introduction of keyhole surgery (laparoscopic surgery) aimed to achieve this goal. It did succeed as well, but was not universally offered to all women who needed gynecological surgery.
Today, there are few reasons for the expert laparoscopic or vaginal surgeon to perform an abdominal hysterectomy, the open surgery with long recovery period. Open hysterectomy should be done less frequently because laparoscopic surgery can be used effectively to accomplish a less invasive hysterectomy in most cases.
However, conventional laparoscopic surgery has a steep learning curve for surgeons as it has two-dimensional imaging and involves mastering counter-intuitive hand movements and is therefore difficult for most Gynaec Surgeons to use proficiently.
According to Dr. Rooma Sinha, senior consultant gynecologist, Minimal Access and Robotic Surgeon, Apollo Health City, Hyderabad who was here in Jamshedpur today robotic surgery is an advanced laparoscopic surgery and the next logical step.
She said like laparoscopic surgery, it can be performed using small cuts. But unlike laparoscopic surgery, precise movement of the instruments helps to perform detailed and complete surgery.
“This is possible because the robotic instruments move like a human wrist unlike the straight stick instrument one uses while performing conventional laparoscopic surgery. Robotic instruments can access hard-to-reach areas of the human body more easily, especially in pelvis during gynecological surgeries. Robotic surgery can bridge that gap between open surgery and keyhole surgery. Contrary to the myth regarding robotic surgery, it is the surgeon and her surgical skill that determines the outcome of the surgery and not the robot as it cannot do anything on its own, ” she said.
Robotic surgery scores over conventional surgery in women
The problem of fibroids or endometriosis is not uncommon in young women.
Usually women suffer from heavy menstrual bleeding. These can cause pelvic discomfort and pain, infertility, difficulty in passing urine or motions or pain during sexual intercourse.
In young women, it is important to have a surgical intervention that can preserve her uterus and other reproductive organs for future child bearing.
For endometriosis (cysts in ovaries with severe adhesion), robotic assisted surgery can give a precise and superior surgical outcome. Robotic assistance with 3D vision and 10 times magnification helps the to completely remove all endometriotic implants which gives better pregnancy outcomes and less recurrences.
In young women with fibroids, only removal of fibroid (myomectomy) and not hysterectomy is the treatment of choice. In this situation robotic assistance helps to remove large fibroids with small holes, avoiding a major surgery.
According to her, robotic surgery is useful in cancer of the uterus like cervical carcinoma and endometrial cancer.
“The surgeries can be done without the need for major cuts with similar results. We have many success stories of women conceiving and delivering after robotic assisted myomectomy at Apollo Hospital, Hyderabad, ” she added.
