Robotic Surgery – An Initial Single Institute Experience in Indian Patients

Jagdishwar Gajagowni, MS, Mchsurgical, oncology, M Bala Vikas Kumar, MS, general, surgery, Sagar Sen, DNB, , General, Surgery, Vandana Godella, MBBS

KRISHNA INSTITUTE OF MEDICAL SCIENCES

Abstract
Minimally invasive surgery has experienced new horizon with advanced tele-robotic technology in its armament.

Design: We intend to describe our single institution experience in robot-assisted surgery using the da Vinci Surgical System in our Department of Surgical Oncology, KIMS Secunderabad,India for several procedures for which traditional laparoscopy has been standard approach.

Methods: Between July2011-September 2012, 64 persons underwent robotic procedures( M-26 , F-38 ,mean age- 50.80 years ,range of age 22-78 years ,mean operative time 237.65 mins ) we performed abdominoperenial resection (9), anterior resection (3), total esophago-gastrectomy (8), esophageal leiomyoma enucleation (2) ,radical hysterectomy (17), simple hysterectomy (6), diagnostic thoracoscopy (1), thymectomy(1) , hemithyroidectomy (6) , whipples (2), nephrectomy (3), adrenalectomy (1) , myomectomy (1),GEJ- GIST excision (1), hemicolectomy(2), oophorectomy (2).

Result: All cases were single procedures. Initial 20 cases the average docking time was 18 mins which came down to 7 minutes.There were 2 conversions to open surgery, 1st case of an adrenalectomy which was found adherent to the diaphragm and another case of nephrectomy wherein the tumor was involving the hilum and space to play the instrument was inadequate.

Conclusion: Our initial experience suggest robotic surgery to be feasible and safe in
usage in daily clinical setting. It requires teamwork of skilled personnel for proper
maintenance and handling. It is a novel approach towards minimally invasive surgery and requires more experience to standardize the best indications and cost-benefit ratio for patients and institutions. In Indian context although still in its infancy, robotic surgery has already proven itself to be of great value, particularly in areas inaccessible to conventional laparoscopic procedures.

Session: Poster Presentation

Program Number: P637