Pushing the frontiers of medicine: Sit back and relax? Robotic surgery is a bit more than that

Experts speak at SIUT's international symposium on minimally invasive surgery


Ishrat Ansari November 25, 2014

KARACHI: When it comes to robotic surgery, people often think that a robot performs the surgery while the surgeon sits back and enjoys coffee. The reality, however, is quite different, says Prof Prokar Dasgupta, the pioneer of robotic urological surgery in the United Kingdom.

He was talking to The Express Tribune after delivering a lecture at an international symposium on endourology and minimally invasive surgery (MIS) organised by the Sindh Institute of Urology and Transplantation (SIUT) at its premises on Tuesday.

"A surgeon controls the robot like a man drives a car," he explained. "The robot, which is a master-slave device, has four arms - a big one and three small ones. As a result of using it, the patient does not suffer from large cuts or excessive bleeding."

Prof Dasgupta, one of the leaders in robotic surgery, is associated with King's College, London (KCL), and is the first Asian editor-in-chief of the British Journal of Urology International (BUJI).

"There is much scope for MIS - called laparoscopy in regard to urological disorders - in Pakistan but training and team spirit is fundamentally lacking in the country," said Matin Khalid Mahmood Sheriff, a consultant urological surgeon at Medway Maritime Hospital in Kent and a visiting professor at SIUT.

"SIUT has conducted 200 such surgeries over the last year, most of which were successful," he added. "The procedure, which involves making several tiny incisions instead of a large cut, is cost-effective, scar-free and less painful." He further discussed in detail the status of nephron sparing surgery, which has gained momentum in recent years, with an increasing number of tumours being detected at early stages.

Meanwhile, Prof Dr Muhammad Shamim Khan, a urological consultant at Guy's and St Thomas Hospital and KCL's medical school, said that for Pakistan, the question lay in timing. "It is not only about buying technology - using it in a sustainable fashion is also crucial," he said. He presented an overview of how to manage clinical Benign Prostatic Hyperplasia and outlined the general principles and recent advances in surgical procedures for enlarged prostates.

"We need to train surgeons, nurses and even administrative staff," said Dr Khan. "Pakistan has three robots, one in Civil hospital but they are lying idle because no one has been trained in their use."

Prof Dasgupta added that India had 20 robots but the situation was similar to that in Pakistan. "Change is coming in India gradually but robotic surgery is quite expensive and only available to the rich," he added. "Our aim is to make it accessible to less privileged people too."

Dr Sheriff, on the other hand, said that India was leading in the field of MIS. "Laparascopic surgery has been slow in developing in Pakistan," he said. "The limitation lie both in acquiring and maintaining the expensive equipment and in the demanding training required to use them." He added that SIUT had invested significantly on both counts, with the result that there were now many trained teams of surgeons in this field. "We must build and invest in a national MIS centre in order to train more surgeons."

SIUT director Prof Adibul Hasan Rizvi introduced the guest speakers and highlighted the significance of robotic surgery and MIS. A large number of surgeons, doctors and students attended the symposium.

Published in The Express Tribune, November 26th, 2014.

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