ROBOTIC SURGERYDR.MEENAKSHI SUNDARAM

CONSULTANT LAPAROSCOPIC AND ROBOTIC SURGEON

DEPARTMENT OF OBSTETRICS & GYNECOLOGY

INSTITUTE OF ROBOTIC SURGERY

APOLLO HOSPITALS, CHENNAI

Click to edit the outline text format Second

Outline Level Third

Outline Level

Fourth Outline Level

Fifth Outline Level

Sixth Outline Level

Seventh Outline Level

Eighth Outline Level

Ninth Outline LevelClick to edit Master text styles

Second level Third level

Fourth level Fifth level

Robotic surgery is the future

Robot-Advanced computer integrated interphase

BREAKTHROUGH TECHNOLOGY

Surgeons must progress beyond the traditional techniques of cutting and sewing ……. ,to a future in which minimal access to the abdominal cavity is only the beginning.”

Pappas, Jacob, NEJM 2004

How can we overcome surgeon and equipment limitation?

Image goes here

HISTORY OF ROBOTICS

LEONARDO DA VINCI ROBOT IN 1495

Term Robot was coined in

1920 from Czech word “ Rabota” meaning laborer

Medical Robotics in 1985-

PUMA 650

Click to edit the outline text format

Second Outline Level Third Outline

Level Fourth Outline

Level Fifth

Outline Level

Sixth Outline Level

Seventh Outline Level

Eighth Outline Level

Ninth Outline LevelClick to edit Master text styles

Second level Third level

Fourth level Fifth level

Click to edit the outline text format

Second Outline Level Third Outline

Level Fourth Outline

Level Fifth

Outline Level

Sixth Outline Level

Seventh Outline Level

Eighth Outline Level

Ninth Outline LevelClick to edit Master text styles

Click to edit the outline text format

Second Outline Level Third Outline

Level Fourth Outline

Level Fifth

Outline Level

Sixth Outline Level

Seventh Outline Level

Eighth Outline Level

Ninth Outline LevelClick to edit Master text styles

Second level Third level

Fourth level Fifth level

EVOLUTION OF ROBOTS

Da-Vinci Robot

Click to edit Master text stylesSecond level

Third level Fourth level

Fifth level

Da-Vinci Robotic arms

Click to edit Master text stylesSecond level

Third level Fourth level

Fifth level

Image goes here

Da Vinci Standard (1999)

Da Vinci S system (2006)

Da Vinci Si system (2009)

Da Vinci Si system at Apollo Chennai

Click to edit Master text stylesSecond level

Third level Fourth level

Fifth level

HIGHLIGHTS OF ROBOTICS-CORE TECHNOLOGY

Surgeon controls the robotic arms

3-D HD vision

Endowrist instrumentation

Intuitive motion

Motion scaling-Filtration of tremors

Replicates high standard of surgery every single time

Open Surgery Laparoscopy Robotic surgery

INCISION 10-20 CM KEYHOLE KEYHOLE

PAIN ++++ ++ +

BLOOD LOSS 700 ML 300 ML 100 ML

SCARS + TINY TINY

SURGICAL AUTONOMY

- - +

POST OP HOSPITAL STAY

5-6 DAYS 2-3 DAYS 36 HRS OR MORE

RECOVERY LONG SHORT SWIFT

MASTERS

Finger “masters” controls which convert human movements into electrical signals that direct the robot instruments

SURGICAL DEXTERITY

Click to edit Master text stylesSecond level

Third level Fourth level

Fifth level

ADVANTAGES TO THE SURGEON

• Immersive view through tiny 1-2cm incisions

• Overcome limitations of human wrist

• Reach inaccessible areas with ease

• Work in limited space

• No risk of transmission of diseases

ADVANTAGES TO THE SURGEON

• Only system that allows surgeons to operate while seated

• Better ergonomics than traditional open and laparoscopic surgery

• Reduced surgeon fatigue

• Minimal invasive approach possible even for Obese patients

ADVANTAGES TO THE PATIENT

• Keyhole surgery• Less pain• Lesser trauma• Less blood loss• Faster recovery• Shorter hospital stay• Less need for medication• Safe, accurate and precise

APPLICATIONS IN CLINICAL PRACTICE

Urology

Gynecology

General Surgery

Cardiothoracic

Head and Neck surgery

Bariatrics

Robotic Urology Procedures Performed

Radical Prostatectomy

Radical Cystectomy

Partial Nephrectomy / Radical Nephrectomy

Adrenalectomy

Pyeloplasty

Ureteral Reimplantation

Urinary Fistula Repair

Robotic Urology Procedures Performed

Radical Prostatectomy

Radical Cystectomy

Partial Nephrectomy / Radical Nephrectomy

Adrenalectomy

Pyeloplasty

Ureteral Reimplantation

Urinary Fistula Repair

Facilitate successful completion of complex laparoscopic procedures

•Advanced endometriosis•Complex layered suturing like in myomectomy•Extensive clearance in malignancy•Precise dissection in Sacrocolpopexy•Accuracy in Tubo-tubal anastomosis

Gynecological Oncology

Radical hysterectomy for cervical and endometrial cancers

Para-aortic and Pelvic lymph node dissection

Trachelectomy

Oophorectomy

DR.MEENAKSHI SUNDARAMCONSULTANT LAPAROSCOPIC AND ROBOTIC SURGEON,

DEPARTMENT OF OBSTETRICS AND GYNECOLOGY

Apollo Hospitals (Main)21, Greams LaneOff Greams RoadChennai - 600006

Phone: +91-44-28290200/28293333