Robotic Surgery - Facts, Myths and Current Status in Urooncology
Q1. Your team recently completed 1000 robotic surgeries in Urooncology. what is the current status of robotic surgery in treatment of urinary tract cancers-how frequently is this technology used?
Robotic surgery is not some futuristic technology which is practised in a few centres of the western world. It is a technology which is here and now, redefining healthcare since 2000. Where available in and the numbers are increasing-robotic surgery is the treatment of choice for localised genitourinary cancers. 90% of prostate cancer surgeries are performed robotically in the western world. Every 16 seconds, a robotic surgery starts somewhere in the world. The surgical robotic market is set to reach 27 billion dollars by 2032. AI powered robotic market is set to grow by 15% every year.
Q2. Are the perceived benefits of robotic surgery truly significant?
Robotic surgery is not cosmetic surgery. It is not just keyhole surgery avoiding a big scar. It is about what is achieved through these keyholes-which is precise removal of the tumour or cancerous organ with less bleeding, better functional recovery and minimal collateral damage to surrounding structures. This results in better cancer control with fewer complications. For example in kidney cancer, the surgeon can remove more complex and larger tumours safely while preserving the remaining kidney, as compared to open surgery.
Q3. Is the robot autonomous? Can it perform the surgery by itself?
Robotic surgery in its current form is a master-slave system. The surgeon controls the robot completely and the robot cannot independently perform surgical steps. In future we hope the robot will be able to perform certain steps which are predetermined previously but currently we are not there yet. So the fear that robot might, in the middle of surgery, be rebellious or perform an unwanted step is unfounded and in the realms of science fiction.
Q4. How frequent is robotic malfunction during surgery? After all it’s a machine.
The chances of the robot malfunctioning leading to stopping the surgery is very rare-in 50000 cases the incidence was reported as 0.38%. It is much less than your chance of dying in a car crash. And in the unlikely event of a robotic part malfunction, we can safely convert the surgery to laparoscopic or open method, without harming the patient.
Q5. Regarding the method of surgery patients often face a lot of confusion about which method to choose-laparoscopic, open, or robotic. Which method is the best for urinary tract cancers?
That debate is a thing of the past and no longer relevant. Various studies have clearly shown the benefits of robotic surgery over laparoscopic and open methods, especially in prostate and kidney cancer surgery. Better and faster functional recovery after surgery-urinary control in prostate cancer surgeries and kidney function recovery in kidney cancer surgeries-along with better cancer control clearly make robotic surgery the treatment of choice where access to a robot and expertise of the surgeon are available.
Q6. What surgeries would benefit the most by the robotic approach in urinary cancer treatment.
The benefits of robotic approach are the maximum in prostate cancer surgeries - radical prostatectomy. 90% of radical prostatectomies in western countries are done robotically. Apart from the general advantages of robotic surgery like less pain and blood loss, the major advantages are faster return of continence and sexual function. Kidney sparing surgery for kidney cancer - partial nephrectomy - is also done better with the robotic approach. For bladder cancer surgeries, removal of bladder and formation of a new bladder by using the patient's own intestines is a complex and long surgery. The use of robotics in this surgery is increasing due to its advantages of precise suturing and lesser chances of complications.
Q7. Robotic surgery is expensive. How difficult is it for our Indian patients to get access to this technology?
The initial cost of a robotic surgery for cancer treatment is more than open or laparoscopic surgery and the cost difference is between one to 1.5 lacs per surgery. However, when you consider the costs saved by earlier return to work of the patient, lesser hospital visits postoperatively, and lesser complications or readmissions, the difference in cost is not all that great. With more and more robotic companies coming in with cheaper robots - including an Indian robot - the cost is going to go down over the next few years.
Q8. What factors should a patient keep in mind while choosing a robotic surgeon for his or her surgery?
It is important to know that merely having a robot in the hospital does not guarantee a successful outcome of the surgery. The man behind the machine is more important - the surgeon's experience, his or her knowledge of the subject, and his expertise in robotic technique are all important in deciding the outcome of the patient. For a cancer surgery which will potentially influence and alter a patient's life, it is important for the patient and the family to exercise due diligence in researching the surgeon's credentials. Select the right surgeon with the right experience and the right technology at the right hospital.
The Gujarat Uro Oncology Associates are ready to manage patients every step of the way, offering expertise, empathy, and unwavering support. To learn more about services and embark on cancer journey with confidence, reach out at +91 75730 04253 or email bakshihemang@yahoo.co.in. Path to healing begins here.