Robotic surgery is one of the most talked about subjects in the medical world today. A revolution in surgery, robot assisted surgery successfully overcomes the limitations of minimally invasive surgery and allows surgeons to operate with enhanced precision, negligible post-operative complications and, thereby, significantly contributes towards improving the quality of the patient’s life post-surgery. This is the first time in India that Medical Robotics is being used for a Thyroidectomy as well as for operating Larynx Cancer. The most significant outcome of robot assisted thyroid surgery is the absence of any scar on the neck of the patient thereby preserving the aesthetics of the neck region, an important indicator of quality of life. Further, robot assisted surgery not only ensures greater precision but also takes care of low loss of blood, less pain, quicker patient recovery, shorter hospital stay and better quality of life post-surgery compared to conventional methods of doing thyroidectomy.
Usage of Robotics in medical surgeries enables high 15X magnification, 3D image with stability, the adoption of Endowrist technology (this technology interprets and refines the surgeon's hand movement into more precise movements and gives the surgeon natural hand-eye coordination) and the automated application of multiple robotic arms.
Dr. H. Sudarshan Ballal, Medical Director, Manipal Hospitals, says, “At Manipal Hospitals, we keep abreast of the rapid developments in medical technology around the globe and incorporate those that help us provide the best standards of healthcare to our patients. Robot Assisted Surgery is a breakthrough technology which improves patient outcomes as well as enhances our surgeons’ skills. With enhanced precision and minimal loss of blood, patients are discharged within 2–3 days of their surgery, with no/negligible scarring in the operated area and also ensuring a better quality of life.”
Case 1: Robotic Thyroidectomy performed on a 20 year old, suffering from thyroid tumor
India’s first robot assisted Thyroidectomy was performed on a 20 year old girl, suffering from a thyroid tumor. She was discharged on the same day of the surgery with excellent cosmesis and functional outcome and had no scars on neck or face, and due care to the vocal box and parathyroid glands was ensured. With minimal blood loss, pain and discomfort, she was able to resume to normalcy and work within 3–4 days.
Thyroid surgeries are mostly conducted on females. Operating on the thyroid gland located in the neck requires an open surgery that results in having a long scar in that throat and neck. However, with Robot Assisted Thyroid Surgery, the thyroid gland can be operated without leaving any scar on the neck, without injuring the recurrent laryngeal nerve that helps in speech and small parathyroid glands that maintain calcium balance in the human body. Robot Assisted Thyroidectomy helps in precise dissection of the area to prevent injury to the vital structures and organs and provides potential benefits of a gasless, endoscopic transaxillary approach. The benefits include:
a. Excellent cosmetic outcome with no neck scars
b. Reduced likelihood of recurrent laryngeal nerve damage and hence, excellent voice
c. Less risk of parathyroid gland damage
d. Reduced likelihood of numbness in the anterior neck
e. Preserves quality of life
The surgery was jointly performed by a team of doctors from Manipal Hospitals Bangalore viz. Dr. Somashekhar and Dr Shabber Zaveri from the Department of Surgical Oncology amd Dr EV Raman from the Department of ENT.
Commenting about her breakthrough surgery, Ms. Kavya , who underwent the Robotic surgery for Thyroidectomy, said, “I am very grateful to Manipal Hospitals for the precision and expertise with which they performed this surgery on me. Being a young and unmarried professional, I found this robotic surgery to be very advantageous as it was scarless and ensured a shorter stay at the hospital and quick recovery period.”
Case 2: Transoral Robotic Surgery performed on a 66 year old man suffering from Larynx Cancer
Robotic Transoral Surgery (TORS) was successfully conducted on a 66 year old patient (male) who was suffering with cancer of the Base tongue and Pharynx Cancer. This patient, presented to the Manipal comprehensive Cancer Center at Manipal Hospital Bangalore required to undergo major surgery with jaw bone split and plating and tracheostomy (making an incision on the anterior part of the neck and opening a direct airway through an incision in the trachea) and long feeding tubes. Surgical access to areas such as inside the mouth, throat and neck is very minimal and causes cosmetic deformity, late recovery and delay in next phase of treatment. However, with TORS, the patient has the advantages of:
a. Avoiding disfiguring of jaw bones (mandibulectomy)
b. Avoiding Tracheostomy
c. Quicker Normal Speech and Swallowing
d. Significantly less pain
e. Less Blood Loss
f. Shorter Hospital Stay
g. Shorter recovery time
h. No scars on face
i. preserves quality of life
For the patient, the margins were all negative for malignancy and his recovery was very fast. He had no scars on his face or neck, no speech problems and no tracheostomy without any associated morbidity of swallowing.
According to Dr. Somashekhar.S.P, HOD, Department of Surgical Oncology, Manipal Hospital, “Robotic surgery will play a vital role in taking the healthcare industry to an all new level in future. Robotic technology not only addresses every aspect of the patient’s needs but also offers tremendous ease for surgeons. In the case of the 20-year old girl, the performance of Thyroidectomy ensured a quick and scarless recovery for the patient and helped the surgeons perform the operation with utmost ease and precision. In the case of the elderly patient with Larynx Cancer, keeping his concerns of age and varied ailments in mind, the doctors performed a Robotic Transoral surgery (TORS) which proved to be very successful, with no side-effects, deformity or harm to any vital organs.”
About Manipal Hospitals:
Manipal Health Enterprises (MHE) is a leading healthcare provider, delivering quality healthcare in India. It is part of the Manipal Education & Medical Group. MHE operates its healthcare network under the brand of “Manipal Hospitals”.
MHE manages an aggregate of 4,400 beds among 15 hospitals, over 10 locations across 4 States in South India. The network of hospitals covers all levels of delivery from primary to secondary to tertiary to quaternary care. It has, over the years, built a significant, committed clinical and healthcare skill pool of over 1,500 doctors and 5,500 nurses, paramedics and support staff, dedicated to its core values of “clinical excellence, patient centricity and ethical practices” and thereby, delivering the highest standards of healthcare to patients. MHE’s hospital network annually services 1.75 million patients in India and from abroad.
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