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Robotic Intervention in Urology

Popularizing Robotic Intervention in Urology By Dr. Sanjay Gogoi

Dr Sanjay Gogoi, Heads the Department of Urology, at the new medical hub, Manipal Hospital, Dwarka, New Delhi, in the bustling neighbourhood of Dwarka, Delhi. Having trained and worked in premium hospitals in India, his immaculate credentials precedes him as an expert in robotic surgery carrying out some of the most noted procedures such as the youngest Robotic Pyeloplasty in a 5 months old child in the country, besides performing in neighbouring island nation, Sri Lanka’s first Laparoscopic Donor Nephrectomy way back in 2003.

He was awarded for these medical feats and several others too. Dr Gogoi is concertedly working at removing people’s scepticism towards robotic intervention by highlighting its incredibly advanced technological virtues that make surgeries minimal invasive, precise, safe and hassle-free.

Robotic Surgeries are Need of the Hour Yet the Awareness of These Latest Advancements is Still Lacking. How do You Think We can Improve Awareness?

It is commonly perceived that Robotic Surgery is performed by a Robot. From a patients’ perspective, resigning oneself to a machine to perform complicated surgeries is daunting. Perhaps people imagine it being like a robot performing its tasks in a vehicle assembly line.

In reality, current generation robots are merely advanced laparoscopic surgical tools. The surgeon sits in a console and operates the Robot which is parked next to the patient. Surgeons hand movements are replicated and many a time enhanced to make complicated surgical manoeuvres, in difficult to access areas of the body. The robot has no autonomy. That’s the reason why the correct description should be Robot-Assisted Laparoscopic Surgery.

In India, we have about 40 installations and most of these are concentrated in a few cities. Lack of awareness has impeded its acceptance as an important surgical tool. It is wrongly thought off as a superfluous. Medical Insurance companies, various central government and state government panels are yet to accept robotic surgeries in the list of approved cases.

Patients who are aware and have medical insurances are currently being denied Robotic surgeries as their policies do not approve of it. It is incumbent on Surgeons trained in Robotic surgeries and health agencies to disseminate this information to the masses through various mediums so that Robotic Surgical Procedures can be assimilated in the mainstream.

As a Proctor in Robotic Surgeries, You’ve Performed Over 500 Cases. Which was the Most Difficult and Challenging One?

Robotic Urology procedures have a wide spectrum. Some are routine, whereas others are very daunting. For me Robot-Assisted Kidney

Transplant and Robotic Bladder Cancer surgeries are the most challenging. Performing a kidney transplant in a very obese individual have potentially serious complications. The robotic platform enables execution of complex vascular anastomosis through small incisions, thereby ensuring better outcomes with lesser complications.

Globally obesity is a serious health hazard and more and more of our obese kidney failure patients, who otherwise would have been denied surgeries are now being treated by Robot-Assisted Kidney Transplantation. Invasive bladder cancers are best treated surgically and for decades the standard of care used to be the removal of the bladder through a long midline abdominal incision.

The urinary drainage was either through a urinary conduit surfacing on to the abdominal wall or creation of a neo-bladder using the intestine. These were thought to be daunting tasks, not possible with minimally invasive techniques. However, the glassing ceiling was broken in the year 1992 when the first Laparoscopic Radical Cystectomy was performed. It was a difficult procedure and only a handful of skilled laparoscopic surgeons could do it. Moreover, due to prolonged operating time and not so convincing statistics, prevented it from wide acceptance.

In 2009, results of Robotic Radical Cystectomy was reported from Sweden, which showed convincing benefits in terms of decreased blood loss and decreased pain which finally translated in early recovery and faster return to normal activities especially in patients with peri-operative morbidity including the obese and elderly.

We are routinely performing this complicated procedure and our results have left us convinced of the benefits.

What are the Services, Treatments and Technology You and Your Team Provide at Manipal Hospitals, New Delhi?

We have the latest itineration of the Da Vinci robot along with advanced intraoperative USG and electrosurgical devices. I head the Urology division and we provide the entire spectrum of Robotic uro-surgical Treatment. The bulk of our work involves Robotic Prostate, Bladder and Kidney cancer surgeries.

We also have a very active renal transplant program and we offer Robot-Assisted Kidney Transplant for medically indicated cases. We are also recognised as an important Robotic Paediatric Urology as well as Female Urology center.

Also, read about da Vinci Robotic Surgery: Risks & Complications

This write-up was contributed to Credihealth by Dr Sanjay Gogoi, Head of the Department of Urology at Manipal Hospital, Dwarka, New Delhi.

For a priority appointment or more information, contact us at +91 8010994994 or book an appointment with Dr. Sanjay Gogoi here –

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