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Tech treat

A robotic surgeon performs advanced laparoscopic surgery for both cancerous and non-cancerous conditions using a surgical robot.

education Updated: Jun 18, 2013 16:43 IST

The lowdown

A robotic surgeon performs advanced laparoscopic surgery for both cancerous and non-cancerous conditions using a surgical robot. The robotic system is equipped with arms for optics and the camera which are inserted into the body and send images to video screens on a console where the surgeon sits. He, then, manipulates a pair of joysticks connected to instruments inserted into the patient’s body which replicate his movements and carry out the surgery. Robotic systems have been utilised in cardiac surgery, thoracic surgery, urology, gynaecology, etc. There are three main limitations when it comes to the scope of robotic surgery in India. First, there are limited numbers of surgical robots primarily because of the high initial and recurring cost of maintenance. Second, there is lack of awareness among the general public as well as physicians about the benefits of robotic surgery. Third, there is also lack of a referral system which aims at connecting a patient through different levels of services such as surgery, medical, consultation... so that he/she can receive optimal health care.

Clockwork
An average day of a robotic surgeon could be as follows:
5.30am: Wake up and get ready and connect with operation theatre staff to ensure the patient has been readied for surgery
6.30am: Leave for hospital
7am: Reach operation theatre, check preparations for surgery, check equipment required for the surgery
10am: Patient wheeled in. Get ready for surgery
3pm: Finish surgery, monitor patient for post-op care and wait for him to regain consciousness
6pm: Prepare report on robotic system to send to manufacturer

The payoff
At a government-aided institute such as AIIMS, the take-home salary for someone at a senior professorial position is about Rs. 1 lakh a month. Someone at that level at a private hospital could be making 10 times more depending on the hospital or city he/she is working in

Skills/TRAITS
* Finely tuned surgical skills with some technological orientation to be able to understand the workings of the robotic systems
* Dealing with high-tech systems which are upgraded constantly means you have to remain updated on everything that is happening in your field
* A desire to achieve cutting-edge excellence in your field and developed ability to network with the best brains

Getting there
Any medical student with a master’s in surgery should first develop proficiency in open surgery before training with the robotic devices. One needs to have basic surgical training and undergo fellowship training for two-three years in a high-volume centre before one is qualified to perform independent surgeries. Robotic surgery is a new and more precise method of doing surgery using the keyhole method with minimal invasion, thus ensuring quick recovery time

Institutes and URLs
At present, India does not have any dedicated training centre for robotic surgery. Various universities in the United States offer fellowship programmes in this discipline for two-three years. Pier Cristoforo Giulianotti, one of the pioneers of robotic technology, and currently chief of the division of general, minimally invasive and robotic surgery, trains surgeons at the University of Illinois at Chicago (www.uic.edu). However, one needs to clear the United States Medical Licensure Examination (USMLE) to apply for these fellowship training programmes. International bodies like the Endourological Society (www.endourology.org) and the Society of Urologic Oncology (www.societyofurologiconcology.org) provide accreditation to institutes in Europe and Asia which offer the relevant programmes

Pros and cons
* An exciting field to be in
* You save lives — what could be better than that?
* High initial capital expenditure and high costs for robotic instruments
* The surgery initially requires extra time and manpower
* With proper training, you can become very proficient in a short period of time

Robotic surgery is the way ahead. Improvement in instrumentation and cost containment will enhance the scope of this surgery further -- Arvind Kumar, director of the Institute of Robotic Surgery at Sir Ganga Ram Hospital, New Delhi