Robotic surgery revolutionises cardiac care at Escorts

The advent of robotic surgery has revolutionised conventional heart surgery, which calls for four-six hours of concentration, expertise and dexterity on the operating table for the surgeon. Robotic surgery saves most of the strain, plus the patient can go soon after operation. In fact, these are not the only advantages, there is much more to the surgery performed by the machines that work like human beings. Nidhi Srivastava spoke to Dr Naresh Trehan, executive director, Escorts Heart Institute and Research Centre, on the developments of the robotic heart surgery. Excerpts.

Is Escorts the only hospital in India to have this kind of surgery?
Yes, not only in India but also in the entire subcontinent, Escorts Heart Institute and Research Centre is the only hospital to have this technology.

What are the advantages and disadvantages of this surgery?
When a doctor performs a heart surgery manually, inspite of all the skill and expertise, in order to see and repair properly, the opening that is made in the body is generally quite large, which leaves its mark after the operation. Also, the patient has to be kept on a heart-lung machine, to stop the beating of the heart during the time of stitching of the cuts. All this together, puts three to four hours of extra work. But with this surgery, the incision made is quite small and we can perform the entire surgery with just two or three holes in the heart. Moreover, with the arms of the robot made in such a way that they can rotate at an angle of 360 degrees, it is possible to reach every nook and corner required. The heart-lung machine is also not needed because with this technology we can actually perform a beating heart surgery. However, at the same time the second-generation robot surgery has its limitations too.

Firstly the technology in India needs to develop a bit more to enable us perform a foolproof operation. It’s actually no point bearing so many expenses and doing an operation for eight hours when a manual operation can also be done in the same or maybe slightly lesser time period. So presently, we are working with the first generation robots only and the satisfaction rate of the patients is quite high - with just one unsuccessful case in a thousand patients.

Which stage of development is the second-generation robot surgery in?
We can say that it is in the advanced stage and in the next two to three years the problems should be sorted out. The main thing that needs to be achieved is that the operation should be less cumbersome and amount of space created in the chest should be reduced. Best would be if keeping all other parameters the same, we can perform the operation through a smaller incision. Presently we are doing it through the first-generation robots that are quite efficient in making small cuts and performing the operation.

How expensive is the operation?
The operation would cost somewhere around 1.5 lakh to the patient.

Considering the high cost of the machine, how do you manage the maintenance?
There is something called value addition. Certain things in life do not give you returns in terms of finances. Like in this case, the better services we offer, the more patients we’ll get. We at Escorts have a policy that the doctors do not charge any personal fee for any surgery. We make a package deal, so only the cost of consumables is borne by the patients. They don’t have to pay for any machinery etc. Since Escorts also has a research centre, such cost factors are taken care by the research funds.