ROBOTIC SPINE SURGERY

We were the first to perform the Da Vinci robotic spine surgery in India and the first in the world for TB of the spine.

The term "robotic surgery" is used to refer to the technology, but it is easy for people to get the impression that the robot is the surgeon.

Actually, the current Robotic Surgical System cannot run on its own. This is due to the fact it was not designed as an autonomous system and lacks decision making software

 

Below is a brief description of the Da Vinci robot and how we have applied this for spine surgery. Our team was declared winner of the “Surgical Team of the Year” at the 2014 BMJ awards (Rewarding excellence in Indian Healthcare).

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Robotic Surgery has been successfully used in the following procedures:

1. General and Gastrointestinal Surgery

2. Bariatric ( Weight loss ) Surgery:

3. Thoracic Surgery:

4. Urology -   Radical prostatectomy

5. Gynecology - Hysterectomy

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LIMITATIONS OF ENDOSCOPY

• The difficulties surgeons have in manipulating instruments, which move in the opposite direction to their hand movements.

• Impaired visual perception, mainly depth.

• It is also not adapted to complex procedures.

• Limited instrument movement.

• Dependence on assistant for vision.

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DA VINCI® ROBOTIC SPINE SURGERY : PARTS OF THE SETUP

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FEATURES

• Surgeon Sitting

• 3D Image

• Image close to hands

• 360 °movement

• Telescope under control

• Three instrument control

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SURGEON'S CONSOLE

• 3D ‘goggles’

• Finger loops to control instruments and telescope

• Arm rest with controls

• Foot pedals for energy devices, switch pedals

 

ADVANTAGES

• Control of telescope and 3 instruments.

• Precision, miniaturization, decreased blood loss due to accurate dissection.

• Further advantages are articulation beyond normal manipulation.

• Three-dimensional magnification, resulting in improved ergonomics.

 

DISADVANTAGES

• Expensive for patients

• Hospitals have a hard time recovering the cost

  

 

Case reports below are of two cases of TB of the spine where the TB abscess was drained robotically through the chest, allowing the spinal cord compression to be relieved. Second stage surgery involved putting pedicle screws posteriorly to stabilize the spine.

 

CASE STUDY 1

 

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Pre – op MRI Image of thoracic TB abcess

Encircled - thoracic TB abcess

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  Post-op X-Ray Images after spine stabilization:

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CASE STUDY 2

 

 

Pre-op MRI Images of the thoracic spine with TB abcess. Encircled - TB Abcess

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Post-op  images after spine stabilisation

 

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SUMMARY

By providing surgeons with superior visualization, enhanced dexterity, greater precision and ergonomic comfort, Surgical Robot makes it possible for more surgeons to perform minimally invasive procedures involving complex dissection more precisely.