Dr Ram Narain, utive Director, Kokilaben Dhirubhai Ambani Hospital

Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute has set up yet another benchmark by launching Da Vinci Robotic Surgery “ a cutting edge healthcare technology. Dr Ram Narain, utive Director, Kokilaben Dhirubhai Ambani Hospital talks about the technology and its benefits

Why did you choose robotics technology for Kokilaben Dhirubhai Ambani Hospital?
The Centre for Cancer at Kokilaben Dhirubhai Ambani Hospital is a comprehensive one stop shop for end to end treatment of cancer. Whether it be high end diagnostic tools like PET CT or genetic typing before starting chemotherapy, organ specific cancer surgeons, radiotherapy in the form of IGRT or IMRT, targeted chemotherapy or bone marrow transplant, it is all available at our hospital. Robotic surgery with its clear benefits in delivering superior outcomes in cancers of the prostate, urinary bladder, kidney, uterus was clearly the next step in expanding our scope of services. With increasing incidence of cancer and early detection due to screening, the subset of patients suitable for robotic surgery is increasing day by day. What is now available in limited centres will become a standard of care as time goes by.

Tell us about your views on the potential penetration of robotic surgery in the hospitals in India.
The potential is enormous in terms of penetration. One year may be too short a span of time to see a change in terms of cost and affordability. However, over a span of three years, we should be able to see a tangible decrease in costs.

Which department would be early adopters of robotics? How does it help the patients and doctors vis- -vis earlier treatment procedures?
Globally UroOncology and Gynaecology are the drivers of the programme. Newer indications are emerging in head and neck, thoracic and gastrointestinal surgery. Patients are benefited in terms of less pain, less blood loss and shorter hospital stay. Doctors benefit by increased range of motion, increased dexterity and enhanced 3D visualisation. We will be expanding the range of services across specialities and set up a truly comprehensive Centre of Excellence in Robotic Surgery.

Tech Connect:
Robotic surgery is a breakthrough surgical technique. It is an effective, minimally invasive alternative to both open and laparoscopic surgery. With the robot, small incisions are made to introduce miniaturised wristed instruments and a high definition 3D camera into the body. This surgical system consists of an ergonomically designed surgeons console, a patient cart with four interactive robotic arms, a high performance vision system and a patented EndiWrist instrument. The surgeon can operate while being comfortably seated before a screen that displays a highly magnified 3D image of the bodys interior.

As the robotic technology is currently used for the cancer treatment, please tell us some of the highlights of this technology?
Besides the benefits mentioned earlier specifically in cancer of the prostate, there is a clear decrease in the incidence of incontinence and impotence after radical prostatectomy. In cancer of the uterus and cervix a much more accurate and precise lymph node clearance is possible. At this point of time cost is a relative disadvantage in terms of capital expenditure and consumables. This will, however, over time be offset by shorter hospital stay due to lower morbidity as against laparoscopic or open surgery.

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