BENGALURU: Fortis Hospital Bannerghatta Road successfully treated a 64-year-old male from Madagascar, suffering from Triple Vessel Coronary Artery disease (blockage in three major arteries), an enlarged prostate, and multiple co-morbidities. A multidisciplinary team of Doctors – Dr. Sudarshan G T, Senior Consultant – Cardio Thoracic Vascular Surgery, Dr Srinivas Prasad, Senior Consultant – Interventional Cardiology and Dr Mohan Keshavamurthy, Senior Director – Urology, Uro-Oncology, Uro-Gynaecology, Andrology, Transplant & Robotic Surgery along with a Vascular Surgeon, ENT Specialist, Endocrinologist, Nephrologist and a Pain & Palliative Specialist treated the patient.

Patient Ramesh (name changed), a cancer survivor and a double amputee, faced a dire health crisis a month ago when he complained of chest pain and shortness of breath. An angiogram – a crucial imaging test that reveals the condition of blood vessels, was performed in Madagascar, which revealed reduced blood flow to the heart (Acute Coronary Syndrome) leading to heart attack and reduced blood flow to the rest of the body (Acute Left Ventricular Failure) highlighting an urgent need for a bypass surgery. However, the conventional bypass surgery was not feasible for Ramesh due to the amputation of both his legs, which meant he lacked viable veins for grafting. Additionally, his severe mobility restrictions, relying entirely on an electric wheelchair, further complicated the matter. Faced with these challenges and the lack of advanced medical technology in his country to address such a complex case, Ramesh sought the expertise of doctors at Fortis Bannerghatta Road for advanced treatment and a chance for improved health.

Upon admission at Fortis Bannerghatta, a comprehensive diagnostic evaluation revealed multiple co-morbidities including triple vessel coronary artery disease, diabetes, acute kidney failure, and an enlarged prostate. Due to financial constraints, hemodynamic-assisted angioplasty – a minimally invasive procedure to improve blood flow through blocked or narrowed arteries was not a viable option. Consequently, Dr Sudarshan and Dr Srinivas recommended a hybrid surgical approach combining traditional open surgery with minimally invasive techniques. The treatment plan involved a robot-assisted minimally invasive bypass grafting (MIDCAB, or Minimally Invasive Direct Coronary Artery Bypass Surgery), followed by a Rotablation atherectomy assisted Angioplasty with Percutaneous Coronary Intervention (PCI). Dr Mohan

Keshavamurthy suggested a UroLift procedure to address the enlarged prostate, while diabetes and kidney failure were managed by the respective specialists.

Explaining the procedure, Dr. Sudarshan G T, Senior Consultant – Cardio Thoracic Vascular Surgery, Fortis Hospital, Bannerghatta Road said, “Given the patient’s complex cardiovascular condition and the high risks associated with traditional open-heart surgery, which requires a large incision in the chest, we opted for a minimally invasive approach called Robot-Assisted Minimally Invasive Direct Coronary Artery Bypass (MIDCAB). This innovative treatment included a surgery designed to tackle one or more blocked arteries using tissues through small surgical cuts. It reduces both recovery time and surgical risks. The surgery took approximately 2 hours and once the patient was stabilized, he was scheduled for rotablation assisted angioplasty with Percutaneous Coronary Intervention – a non-surgical procedure to treat the blockages in the artery.”

Dr Srinivas Prasad, Consultant- Interventional Cardiology, Fortis Hospital, Bannerghatta Road “We performed Rotablation assisted angioplasty with Percutaneous Coronary Intervention on the patient, during which a tiny, diamond-coated tool that rotates at high speed was used to grind away hard, calcium deposits inside arteries. After the calcium deposits are cleared, a catheter with a balloon at the tip is guided to the site of the blockage in the artery, thereby widening the artery and improving blood flow. A drug-releasing stent was then placed in the artery to keep it open after the balloon was removed. This drug is slowly released into the artery wall over time, preventing the regrowth of tissue within the artery. The procedure lasted for around 45 minutes to an hour. Following the procedure, the patient was monitored in the hospital for 3-4 days and then underwent a week of physiotherapy to aid in his recovery. This timely intervention significantly contributed to the patient’s recovery and overall health improvement. In the absence of these surgical interventions, in case the patient suffered another heart attack it would have been difficult for the patient to survive.”

Dr Mohan Keshavamurthy, Senior Director – Urology, Uro-Oncology, Uro-Gynaecology, Andrology, Transplant & Robotic Surgery at Fortis Hospitals, Bengaluru said, “Following the successful cardiac surgery, we proceeded with the UroLift procedure to address the patient’s enlarged prostate also known as Benign Prostatic Hypertrophy (BPH). BPH is a common condition that affects over 70% of men in their 60s. Although benign and unrelated to prostate cancer, BPH can significantly impact a man’s quality of life. As the prostate enlarges, it presses on and blocks the urethra (the tube through which urine leaves the body), potentially leading to permanent bladder damage if left untreated. To address this, we opted for the minimally invasive UroLift technique where 4 small implants were placed to gently lift and hold the enlarged prostate tissue away from the urethra preventing blockage. This approach improves urine flow and preserves ejaculatory function without the need for more invasive surgery. Given the complexity of the patient’s medical condition, this technique was particularly well-suited and crucial to his overall recovery and well-being.”

Akshay Oleti, Business Head, Fortis Hospitals, Bengaluru said, “At Fortis Hospitals, our mission is to provide world-class medical care tailored to the unique needs of each patient. We are proud to have offered a comprehensive and innovative approach to Ramesh’s complex health challenges. By leveraging our advanced medical technologies and the expertise of our multidisciplinary team, we were able to deliver a seamless treatment experience. This case exemplifies our commitment to combining cutting-edge techniques with compassionate care to achieve the best possible outcomes for our patients.”

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BENGALURU: Dr. Muralidhar S. Kathalagiri, a renowned Consultant Laparoscopic, Bariatric, and Gastrointestinal Surgeon at SPARSH Hospitals in Bangalore, has hailed robotic surgery as a groundbreaking technological advancement in the field of medicine. In a recent article, he highlighted how this innovative approach is transforming the landscape of complex gastrointestinal procedures, resulting in enhanced surgical outcomes, improved patient safety, and reduced healing and recovery periods.

According to Dr. Kathalagiri, one of the key advantages of robotic surgery in complex gastrointestinal procedures is the enhanced visualization provided by the robotic system. Surgeons can access a three-dimensional, high-definition view of the surgical site, which allows for better identification of anatomical structures, improved depth perception, and increased precision during intricate maneuvers. This level of visualization aids in reducing the risk of accidental tissue damage and enables surgeons to navigate complex anatomical structures with greater accuracy.

Robotic-driven surgical systems are equipped with robotic arms that can replicate the precise movements of a surgeon’s hand with enhanced dexterity. This allows for meticulous dissection, which is particularly crucial in procedures such as colorectal surgeries, pancreatic surgeries, complex hernia surgeries, esophageal surgeries, etc. The robotic mechanism can perform complex movements with increased stability, providing surgeons with greater control and precision throughout the procedure.

Robotic surgery also facilitates a minimally invasive approach to complex gastrointestinal procedures such as Pancreas Surgery, Liver and Bile Duct Surgery, etc., enabling several benefits for patients. The robotic arms are inserted through small incisions, minimizing trauma to surrounding tissues and reducing post-operative pain. This approach results in shorter hospital stays, quicker recovery times, and reduced risk of complications, such as infections and wound healing problems. The smaller incisions also lead to improved cosmetic outcomes for patients.

Traditional laparoscopic surgery often requires surgeons to maintain uncomfortable positions and perform repetitive movements for extended periods. Robotic systems address this challenge by offering improved ergonomics for surgeons. They can sit comfortably at a console, controlling the robotic arms with precise hand movements and using foot pedals for additional functions. This ergonomic advantage reduces surgeon fatigue, enhances concentration, and allows for longer, more complex procedures with increased precision.

Robotic surgical systems are continually evolving, integrating advanced technologies to further enhance precision and safety in gastrointestinal procedures. By combining the skills of surgeons with robotic technology, procedures such as colorectal surgeries, pancreatic surgeries, complex hernia surgeries, esophageal surgeries, and others can be performed with enhanced visualization, increased precision, and reduced invasiveness.

Robotic surgery has ushered in a new era of precision and safety in complex gastrointestinal procedures. The continuous advancements in robotic surgical systems offer a promising future for the field, with the potential to further improve patient outcomes, minimize risks, and revolutionize the surgical approach to gastrointestinal conditions.

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The event’s highlight was the esteemed presence of Mr. Ramesh Chavhan, CEO of Zilla Parishad, who graced the occasion as the Guest of Honour. Mr. Chavhan inaugurated the championship and expressed his appreciation for the real-world problem-solving projects created by the students.

A significant milestone was the participation of students from Zilla Parishad and PMC schools, marking the first-ever collaboration between these students and their counterparts from the private sector. This inclusivity was not just celebrated but also showcased through the remarkable achievements of students from Zilla Parishad and PMC schools, who secured podium positions.

The competition featured multiple categories, including Line Follower, Maze Solving, and Sumo Wrestling Robots, which showcased the students’ exceptional technical prowess and problem-solving skills. BMC Software’s CSR-supported school, B T Shahani Navin Hind English Medium School in Bhawani Peth, Pune, secured three podium positions. ZS India’s CSR-supported Zilla Parishad Prathamik Shala Lohegaon School secured two podium positions. Globant India’s CSR supported Shrimant Shivaji Raje Bhosale School in Phaltan secured one podium position, and WNS Global Services (P) Ltd.’s CSR supported Gurunanak School in Ganeshpeth secured one podium position.

Ms Payal Rajpal, Director of Robotex India, stated, “Robotex India continues to lead the charge in fostering STEM education, innovation, and inclusivity among India’s youth. With 1 million students educated in pan-India on future employable skills, we aim to train over 2 million by 2024. We are dedicated to bridging the gender gap in STEM and preparing students from marginalized communities in rural India for the jobs of the future.“

The event served as a testament to Robotex India’s commitment to providing a dynamic platform for young talents to showcase their technological innovations on both national and international stages, furthering their exposure to STEM and Robotics competitions. The organization’s dedication to creating a level playing field for students of all backgrounds and nurturing a spirit of innovation and technological excellence was evident throughout the event.

The Robotex India regional championship held at the College of Engineering Pune was a resounding success, with students from Zilla Parishad and PMC schools securing podium positions. The event showcased the exceptional technical prowess and problem-solving skills of the students and highlighted Robotex India’s commitment to fostering STEM education, innovation, and inclusivity among India’s youth.

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MUMBAI: Intuitive, a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery, has installed its hundredth robotic-assisted surgical system in India at the U.N. Mehta Institute of Cardiology, the country’s largest cardiac center. The installation was marked at an event attended by the Hon. Prime Minister of India, Mr. Narendra Modi.

“We strive at Intuitive to help Indian surgeons and their care teams improve patient outcomes, improve the patient and care team experience, and lower the total cost to treat,” said Mandeep Singh Kumar, Vice President and General Manager of Intuitive India.

“We are excited by the commitment hospitals have made to minimally invasive care, including robotic-assisted surgery. Intuitive is honored to help hospitals across India establish and grow their robotics programs through the Intuitive ecosystem, which includes technical training and unparalleled customer support and service. And, Intuitive is energized by urban as well as more rural locations adopting advanced surgical technology,” said Mr. Kumar.

While commenting on the installation of Intuitive’s da Vinci Xi system, Dr. Chirag Doshi, Head, of Cardiovascular and Thoracic Surgery, U.N. Mehta Institute of Cardiology, said, “We are always at the forefront in finding newer ways to offer advanced and affordable healthcare that help improve patient outcomes. With the installation of Intuitive’s da Vinci Xi surgical system, we hope to potentially enhance academic research and residency training programs in the field of cardiothoracic surgery and continue our efforts towards improving patient care and experience.”

Prior to this most recent milestone, Intuitive has thoughtfully advanced minimally invasive care in India through advanced robotic technology, supported by an innovative and expanding ecosystem of learning, services, and solutions. Most robotic programs are installed in leading private and government hospitals, Medical Education Institutes, and State Government Medical Colleges across the country. More than 800 surgeons have been trained on Intuitive’s da Vinci technology and are helping drive the significant increase in its adoption.

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