Sir Ganga Ram Hospital, New Delhi, India

Robotic Surgery

Introduction

Robotic surgery, computer-assisted surgery, and robotically-assisted surgery are terms for technological developments that use robotic systems to aid in surgical procedures. Robotically-assisted surgery was developed to overcome both the limitations of minimally invasive surgery or to enhance the capabilities of surgeons performing open surgery. Robotics is the latest addition to the armamentarium of surgeons. It is a quantum jump in the way surgical procedures are carried out with proved superior patient outcomes. Robotic Surgery can play a vital role in the fields of Thoracic Surgery, Vascular Surgery, General Surgery, Cardiac Surgery, Gastrointestinal Surgery, Gynecology, Neurosurgery, Orthopedics, Pediatrics, Radiosurgery and Urology.

The Institute of Robotic Surgery (IRS) at Sir Ganga Ram Hospital (SGRH) has been conceptualized as an International Centre of Excellence in the field of Surgical Robotics. IRS offers its services to its patients under the supreme leadership of Dr. (Prof) Arvind Kumar. He believes in the motto “Excellence is not an option, but a necessity”.

Dr. Kumar is the first surgeon to start Robotic Chest Surgery in India – at the All India Institute of Medical Sciences, New Delhi in June 2008. Dr. Kumar took voluntary retirement from All India Institute of Medical Sciences in March 2012 and joined Sir Ganga Ram Hospital as Director, Institute of Robotic Surgery,where he performed hospital’s First Robotic Surgery on the fourth day after his joining. It’s under his aegis and efforts that Sir Ganga Ram Hospital has become Asia's first hospital to deliver successful Robotic Vascular Surgery. Institute of Robotic Surgery has completed their first 100 Robotic cases within the first 5months of the setup of the institution and the team has taken the pledge to complete the next 100 cases very soon.

The Setup

The machine

We are proud to announce procurement of the latest generation da Vinci Si Robotic Surgical System with simulator facility from M/S Intuitive Surgical INC. (USA). This machine is worth over `10Cr. was installed at OT no.6 in the main theatre complex of Sir Ganga Ram Hospital on 15th March 2012 and its first surgery (Robotic Thymectomy for Myasthenia Gravis) was successfully performed the very next day by Prof. Arvind Kumar, the director of the institute.

We are proud to announce that we are the only centre with simulator facility in this surgical robotic system, where in, the surgeons can actually perform a virtual operation before performing the actual one.

The men behind the machine

Sir Ganga Ram Hospital is proud to announce this set-up of a multi-disciplinary team of highly trained surgeons under the leadership of Prof. Arvind Kumar, former professor of surgery and thoracic and robotic surgeon from All India Institute of Medical Sciences, New Delhi. Realising the highly skilled nature of these operations, we have created several divisions under the institute of robotic surgery, each dedicated to a sub-speciality with a senior, highly trained consultant heading the division.

Objectives of IRS

The Institute of Robotic Surgery (IRS) at Sir Ganga Ram Hospital has been conceptualised as an International Centre of Excellence in the field of Surgical Robotics, with the following objectives:

  • State of the art Surgical CareThe motto is to achieve excellence by collective wisdom. This is made possible by a team of leading surgeons in their respective fields working along with a team of highly competent and dedicated anaesthesiologists, physicians and nurses.
  • Training and ResearchIRS promotes training of surgeons and ancillary staff in Robotic Surgery which is a relatively new field .We have already organized country’s first CME on Robotic Vascular Surgery .We now plan to conduct CME and training programs on regular basis.
  • Technology DevelopmentThe Institute of Robotic Surgery also participate in development of better and new technology in health care and will work hard to make this technology cheaper.

Services offered

  1. Thoracic Surgery & Surgical Oncology
    • Thymectomy for Myasthenia Gravis and Thymomas
    • Lung Surgery (Infections and Cancer)
    • Esophageal (Food Pipe) Cancer Surgery
    • Heller Myotomy for Achalasia Cardia
    • Diaphragmatic Hernia
    • Mediastinal Tumour
  2. Minimal Access & Bariatric Surgery
    • Bariatric (Obesity) Surgery
    • Fundoplication for GERD/Hiatus Hernia
    • Gall Bladder Surgerys
    • Hernia Surgery
    • Colon and Rectal Surgery
    • Solid organ Surgery including
    • Spleen and Adrenal Surgery
  3. Urology
    • Radical prostatectomy for prostate cancer
    • Radical cystectomy for bladder cancer
    • Kidney Surgery
    • Partial Nepherctomy
    • Pyeloplasty
    • Nephrectomy
  4. Gynaecology
    • Hysterectomy
    • Ovarian cyst Surgery
    • Tubal recanalisation
    • Sacrocolpopexy
    • Wertheim’s hysterectomy
  5. Vascular Surgery Thyroid Surgery (Scarless)
    • Atheroscelerotic aortic blockage
    • Abdominal Aortic Aneurysm
  6. ENT & Sleep Disorders

Robotic Surgery: How does it work?

Robotic surgery refers to computer-assisted surgery, and robotically-assisted surgery are terms for technological development that uses robotic systems to aid in Surgical Procedures. Robotically-assisted surgery was developed to overcome both the limitations of minimally invasive surgery as well as enhance the capabilities of surgeons performing open surgery.

In the case of robotically assisted minimally invasive surgery, instead of directly moving the instruments, the surgeon uses a pair of joysticks on the master console to control them. Master console allows the surgeon to perform the normal movements associated with the surgery using joystick whilst the robotic arms carry out those movements using end-effectors and manipulators to perform the actual surgery on the patient. With robotic surgery, surgeons can offer state-of-the-art treatment that are equal or better than the conventional surgery –and with the potential benefits of a minimally invasive procedure

Technology

The da Vinci Surgical System is a robotic surgical system made by Intuitive Surgicals, USA and designed to facilitate complex surgery using a minimally invasive approach. The system is controlled by a surgeon from a console. The da Vinci System consists of a surgeon’s console that is typically in the same room as the patient and a patient-side cart with four interactive robotic arms controlled from the console.Three of the arms are for tools that hold objects, such as a scalpel, scissors or unipolar or bipolar electrocautery instruments. The fourth arm is for an endoscopic camera with two lenses that gives the surgeon full stereoscopic vision from the console. The surgeon sits at the console and looks through two eye holes at a 3-D image of the procedure, meanwhile manoeuvring the arms with two foot pedals and two hand controllers. The da Vinci System scales, filters and translates the surgeon's hand movements into more precise micro- movements of the instruments, which operate through small incisions in the body.

Advantages of Robotic Surgery

  • Highly Precise
  • Small incisions
  • Much less blood loss
  • Significantly Less pain and Reduced use of pain medication
  • Quicker healing time
  • Reduced duration of hospital Stay
  • Faster return to Work

The Team IRS

Dr. D.S Rana

Chairman, Board of Management, SGRH

Prof. Arvind Kumar

Director, Institute of Robotic Surgery

Minimal Access & Bariatic Surgery Division 

  • Dr. Praveen Bhatia, Chairman (981008507, bhatiaglobal@gmail.com)
  • Dr. Vivek Bindal, Consultant (9999931958, bindal.vivek@gmail.com)

Chest Surgery & Surgical Oncology Division

  • Prof. Arvind Kumar, Chairman (9810765405, arvindreena@gmail.com)
  • Dr. Belal Bin Asaf, Associate Consultant (999965855, asafbelal@gmail.com)

Urology division 

  • Dr. Sudhir Khanna, Senior Consultant (9810195227, sk1957@gmail.com)
  • Dr. Ajay Sharma, Senior Consultant (9810154841, drajay303@hotmail.com)

Gynaecology division 

  • Dr. Debasis Dutta, Senior Consultant (9810054528, drdebasisdutta@gmail.com)
  • Dr. Chandra Mansukhani , Senior Consultant (9810134598, drchandra2008@rediffmail.com)
  • Dr. Mala Srivastava, Senior Consultant (9811228336, malasrivastava2001@yahoo.co.in)
  • Dr. Kanika Jain, Consultant (9811022255, dr.kanika@gmail.com)
  • Dr. Mamta Dagar, Consultant (9811437782, mamtadagar2004@gmail.com)

Vascular Surgery division 

  • Prof. Arvind Kumar, Senior Consultant (9810765405, arvindreena@gmail.com)
  • Dr. Sandeep Agarwal, Senior Consultant (9910779926, sagarwal3566@yahoo.com)
  • Dr. Ajay Yadav, Consultant (9717183355, ajay.vascular@gmail.com)
  • Dr. Ambarish Satwik, Consultant (9810079179, asatwik@gmail.com)

ENT & Sleep Disorders division

Dr. Devinder Rai, Vice-Chairperson (9811009393, draient@hotmail.com)

Achievements of IRS

Performed Asia’s first Robotic Aortic surgery under the guidance of Prof. Arvind Kumar

AortoBifemoral Bypass is performed for patients with significant Aorto-iliac Atherosclerotic disease. This Aortic surgery involves using a Y-graft to bypass the obstruction and take blood from Aorta to both the femoral arteries (groin), thereby supplying adequate blood to both legs. Traditionally, the graft-Aorta Anastomosis of this Aortic Surgery was done by open method involving big cut across whole of abdomen. Attempts at doing this Aortic Surgery by Key-Hole method (Laparoscopy) were not successful because of difficulty in suturing. Now, for the first time in Asia, this complex Aortic Surgery is being done by Key-Hole method with Robotic assistance at Sir Ganga Ram Hospital, New Delhi.

  • Largest experience of robotic thymectomies in India.
  • Largest number of cases completed successfully in the inaugural month.

https://www.youtube.com/watch?v=V7bVWCiv9Lk

“I congratulate the team IRS @ SGRH for achieving many milestones in its very first month of existence. I wish them good luck in their future endeavours for better patient care. I am sure, in the years to come, IRS @ SGRH will bring many laurels to the country”

Dr. D.S. Rana Chairman, Board of Management,
Sir Ganga Ram Hospital

“Team IRS @ SGRH is committed to take the Institute of Robotic Surgery to the pinnacle of safe surgical care. We will do everything poss

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