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.

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.

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.

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

 

Minimal Access & Bariatic Surgery Division 

• Dr. Praveen Bhatia, Chairman (981008507, [email protected])
• Dr. Vivek Bindal, Consultant (9999931958, [email protected])

Urology division 

• Prof. Sudhir Khanna, Senior Consultant (9810195227, [email protected])
• Prof. Ajay Sharma, Senior Consultant (9810154841, [email protected])

Gynaecology division 

• Dr. Debasis Dutta, Senior Consultant (9810054528, [email protected])
• Dr. Chandra Mansukhani , Senior Consultant (9810134598, [email protected])
• Dr. Mala Srivastava, Senior Consultant (9811228336, [email protected])
• Dr. Kanika Jain, Consultant (9811022255, [email protected])
• Dr. Mamta Dagar, Consultant (9811437782, [email protected])

Vascular Surgery division 

• Dr. Sandeep Agarwal, Senior Consultant (9910779926, [email protected])
• Dr. Ajay Yadav, Consultant (9717183355, [email protected])
• Dr. Ambarish Satwik, Consultant (9810079179, [email protected])

ENT & Sleep Disorders division

Dr. Devinder Rai, Vice-Chairperson (9811009393, [email protected])

Achievements of IRS

Performed Asia’s first Robotic Aortic surgery

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.

“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”