Robotic surgery commences in private sector

LAHORE : The Robotic Surgery, the latest surgical technology, has commenced in the private sector in Lahore after successful surgeries upon patients requiring surgical interventions for urological, surgical and gynecological complications.

“The doctors at National Hospital, Defence, have successfully performed Robotic Surgery upon five patients of Surgery and four each requiring Gynecology and Urology surgeries,” informed Prof Dr Mahmood Ayaz, Professor of Surgery, while addressing an awareness session on the start of Robotic Program here at National Hospital Robotic Centre on Saturday.

The Robotic Surgery was first time launched in Pakistan at Sindh Institute of Urology and Transplantation (SIUT) in Urology specialty.

While illustrating the concept of robotic surgery, Prof Mahmood Ayaz informed that the surgeons remotely control robotic arms to mimic human arms with greater precision to perform surgeries upon patients. On average, it took 2 hours and 5 minutes to complete surgery upon each patient requiring surgery, 1:48 hours upon Gynae patient each and 2:15 hours upon each Urology patient.

Prof Mahmood Ayaz said that the specialist doctors, nurses and ancillary staff acquired specialized training abroad and performed mock run at the hospital before starting robotic surgery upon patients in the hospital. In 237 years’ history of surgery through open body procedures, a laparoscopic surgery (surgery performed through holes rather than opening of body) was landmark intervention introduced some 30 years ago, and now robotic surgery is a revolutionary innovation in surgical sciences for the betterment of patients. “Laparoscopic was a 2D intervention, while robotic surgery is a 3D procedure and therefore has high precision and minimizes complications,” he added. He further informed that the robotic arm have far more flexibility than traditional rigid instruments or human arms as it can easily navigate even at 720º as compared to human arm that can navigate up to 180º. He informed that the Robotic system has inbuilt artificial intelligence (AI), which not just rules out human error but also prevent skipping of certain steps during surgical procedure. “If a certain step is skipped, it will first ring an alarm to warn and then instrument will stop until that step is not completed,” he added. He informed that AI in the installed robotic system is linked to the central system through uninterrupted high-speed Internet, which rules out malfunctioning of AI. “Initially, the surgeon’s console is set up within the operation theatre,” he said, adding that the surgeon’s console can be set up in another room of the hospital or even it can be set up at surgeon’s home or clinic without compromising on perfection of procedures. “The surgeon is accompanied by a fellow surgeon, just like co-pilot in aviation, in case of assistance,” he added.

He further informed that human-hand surgery runs the risk of 5.3% rate of infection, laparoscopic surgery 2.9%, while robotic surgery only has the risk of 0.3% rate of infection due to lack of direction human interaction with the patient’s body.

He informed that the cost of robotic surgery would not be in excess to the cost incurred on laparoscopic surgery, except may be 10 to 20% on disposable instrument charges to be borne by the patient.

Prof Dr MR Zaki, Professor of Urology, informed that the robotic surgery only targets the malignancy without affecting the healthy parts of the organ, which makes it even safer for the patients. “The patient can walk away a day after the surgery, unlike in human-hand or laparoscopic surgery, which reduces beds’ occupation in hospitals,” he added.

Prof Dr Samia Malik, Head of Gynecology, said that up to 70 to 80% Gynecological surgeries could immediately be shifted to robotic surgery, while 20 to 30% surgeries may still have to be performed through prevalent methods.

Prof Mahmood Ayaz further said that robotic surgery is the future, saying that Robotic Surgery Database Registry would be set up; a Fellowship in Robotic Surgery would be launched with the collaboration of College of Physicians and Surgeons Pakistan (CPSP); and legislation would be moved to provide legal cover to patients.

Besides, Lt Col (retd) Usman Jilani Khan, Prof Dr Sarwar, Prof Waris Farooqa, Prof Rabia Shahab, Prof Maimoona Hafeez, Prof Rizwan Aftab, other doctors, nurses and staff of the hospital was also present on the occasion.