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Robots are now part and parcel of modern medical world ,previously for doing security of our house ,caring for our needs in home,doing all our house hold activites ,understanding our command to receive our visitors,relatives at our home and office and offer them welcome and a warm reception to cooking our food ,serving on lunch or dinner table,locking our house ,office to be remain secutiy watcher all the day,night,giving us medicines,caring our old parents at home,taking them to doctor,calling doctor serving them with medicines ,every useful Robot is now a days avaible in market ,yes,it is a luxury and come with a hefty price and mostly usedin western or japanese world where lack of human service is present and people are so rich and affluent that money or price is nothing before purchasing any technolodgy or any help service for their house hold or official work.PARO,A THERAPETIC ROBOT AT THE COST OF DOLLAR 21THOUSAND is purchased in US for the senior and old senior citizens by their family members or themselves.
But Robot in medical field has also brought a revolution ,whether to perform a cardiac surgery without making a big cut in chest wall as in open surgery or a big cancer sugery of Prostate or oesophagus where space is limited and ofter we cannot reach to cancer involved part perfectly and cause more damage to near by structure or cannot remove the tumor completely but this ROBORT does it precisely in any narrow space,remove tumor completely, arrest bleeding with minimum injuries to surrounding structures so less post operative complications.so if we want to perform major surgeries through the smallest of incisions with the benefits of a definitive treatment but with the potential for significantly less pain, shorter hospital stay, faster return to normal daily activities as well as better clinical outcomes! The product is called ROBERT OF "DA VINCI " in name and honour of great inventor Leonardo da Vinci who first invented the first robot.
DA VINCI used his phisical knowledge of light and its mechanical utility along with its use in medicine by calculating unparelleled anatomical accuracy and three dimensional details to bring his masterpieces to life. It provides surgeons with such enhanced detail and precision that the system can simulate an open surgical environment while allowing operation through tiny incisions. With the da Vinci Surgical system hospitals are rewriting accepted standards for surgical care and changing the experience of surgery for difficult cancer surgeries of prostate,colon,retoperitoneal tumors,breast,pancreas,liver,kidneys,oesophagus ,ovaries,and mediastinal and brain tumors,liver and kidney transplant surgeries . This breakthrough technology is an effective minimally invasive alternative to both open surgery and laparoscopy. as cost is the factor otherwise even any surgery as removal of appendix or gall bladder of herni or hydrocoele can be done.
ONE ROBOT comes with a price of -6-10 crores in our country so they cannot be established every where in our country ,government is yet to bring ROBOT in premier institute like AIIMS OR PGI CHANDIGARH but PRIVATE PLAYERS who have hijacked whole our Meical industry with the help of Insurance company and charging ROBOTIC even for minor procedures or medical illness has brought ROBOT.ROBOTIC SURGERY IS NOW AVAILABLE IN APPOLO HOSPITAL many branches in Delhi,CHennai,Ganga ram Hospital,Few centres of Fortis and Max Hospital and Gigantic Meidcity of Guragoan or many centres in Banglore and Hyderabad. to serve the so called affluent section of our society or bringing patients from Gulf,UK,USA,Afghanistan,Nigeria,South Africa,Bangladesh,Nepal,Bhutan,Pakistan or srilanka ,japan etc.,in name of cheap treatment and Medical Tourism.
Through the use of the da Vinci Surgical system, surgeons are now able to offer a minimally invasive option for complex surgical procedures. Some of the major benefits experienced by surgeons using the da vinci over traditional approaches have been greater surgical precision, increased range of motion,improved dexterity, enhanced visualization and improved access, Benefits experienced by patients include a shorter hospital stay, less pain, less risk of infection, less blood loss, fewer transfusion, less scarring, faster recovery and a quicker return to normal daily activities.
Robort is not a very specilised human being NOR IT IS MASTER BUT it is SLAVE OF SURGEON,SURGEON SITS IN ITS CONSOLE out side OPERATION THEATRE 2-5 METERS AWAY OR SOME TIMES MILES AWAY IN OTHER COUNTRY AND HE SEES THE OPERATION FIELD AND THEN DECIDES HOW TO OPERATE HE IDENTIFIES STRUCTURES LIFT THEM CUT THEM BY PRESSING DIFFERENT BUTTONS AS WE DO IN COMPUTER OR ANY OTHER DIGITAL DEVICE,ROBOT ITSELF DOESNOT PERFORM SURGERY AS OUR HOUSEHOLD OR OFFICE ROBOT DO as programmes are reloaded in them and they do as per their programme but here surgeon every time gives command and these command are small precise and for time as required by Surgeon if surgeon does not understand ROBOT AS A SLAVE will follow it and cut wrong structure,it has no brain,it is controlled by surgeon's brain.So,no surgical outcome can be guaranteed, as surgery is necessarily both patient and procedure specific.
While clinical studies support the effectiveness of the Robotic surgeries, individual results may vary,There are no guarantees of outcome. All surgeries involve the risk of complications. Before we decide on surgery, we should discuss treatment options with patient and vice versa . Understanding the risk of each treatment can help us make the best decision for our individual situation so that post op consumer court cases may be avoided even civil and criminal cases avoided,so better to discuss every thing in detail and take written consent of patient in writing before proceeding for any surgery .For every patient ,it should be understood that it is a same type of surgeries as done conventionally by open method only procedure use ROBOT as instrument then man made Scissors and forcep of open instruments or laproscopic instruments ,only surgeon sees the structure sharply with the use of Computerised instruments and mini digital cameras .
The system replicates the surgeons movements in real time. It cannot be programmed, nor can it make decisions on its own to move in any way to perform any type of surgical maneuver without the surgeons input. Does the surgeon have any sensations while performing the procedures ? The system relays some force feedback sensations from the operative field back to the surgeon throughout the procedure. This force feedback substitutes for the tactile sensation and is augmented by the enhanced vision provided by the high resolution 3D view. Although seated at a console few meter away from the patient, the surgeon views an actual image of the surgical field while operating in real time through tiny incisions,using miniaturized, wristed instruments. The system does not maneuver on its own outside of the surgeons direct, real time control.
Robotic surgery, a new tehnology in different parts of the world has its disadvantages also. Its uses and efficacy has not been fully determined. There are not many long term studies on this to confirm or deny its effectiveness. The prominent disadvantages to robotics include Time, Cost , Efficacy and its Compatibility with current and existing conditions with hefty price which is a dream for even middle class in country like India what to talk of poor class. Robotic assisted heart surgeries can take nearly twice the amount of time and the patients are under anaesthesia for longer time . It definitely is more expensive.The cost may fall as surgeons gain more experience and start doing it more often but as the system gets upgraded and improved there are chances that the price may even go higher. Only when these systems gain more multidisciplinary use will the cost become more justified. Another disadvantage is the large system in an overcrowded operating room. The robotic arms are awkward and bulky and there are many instruments needed in the small space. For robotic assisted beating heart surgery the space is even smaller because stabilizers are needed. This cramped area can cause interference with the dexterity of the surgeon. The solution is to miniaturize the robotic arms or have larger operating areas. With either solution, robotics is an especially expensive technology. Current operating room instruments are not compatible with new robotic system. Without the correct equipment, tableside assistance is needed to perform part of the surgery. But with time and improvement in technology, these disadvantages will hopefully be remedied and we shall have a day when robot will be placed on patient on ot table programme will be loaded and like Human Brain or Surgeon it will take decision at every momment recognising normal and abnormal tissue or structur and performing difficult sergeries in no tme with very good result and post opeartive complication utilising less human resource and cost.