Minimal Access Robotic Surgery

The Centre for Minimal Access Robotic Surgery at Aster MIMS is the first of its kind in North Kerala. The centre boasts of the revolutionary minimal access surgical system, also known as the Da Vinci Robotic Surgical System. Robotic or robot-assisted surgery allows surgeons to perform complex procedures with more precision, flexibility and control than conventional techniques. The option of Robotic Surgery is available in Urology, Gynaecology, Oncology, Gastrointestinal Surgery and Paediatric Surgery departments. With highly experienced surgeons trained in robotic surgery, we will deliver superior treatment solutions for patients at an affordable cost.

The less invasive procedure gives fewer complications, less pain with minimal blood loss, smaller & less noticeable scars, and faster recovery. The robotic system helps in reaching organs and areas where human fingers cannot. The 3D magnified HD view helps in preventing collateral damage to healthy tissues. Da Vinci system is also equipped with a Firefly Fluorescence Imaging technology that helps identify targeted anatomy better.

ROBOTIC RADICAL PROSTATECTOMY FOR PROSTATE CANCER (RARP)

RARP is the gold standard treatment for localized prostate cancer. It involves the complete removal of the prostate gland using robotic surgery. The Prostrate is located deep in the pelvic cavity. This gland is surrounded by vital structures like the venous complex, rectum, sphincter muscles responsible for urinary control and nerves responsible for sexual functions. During traditional prostatectomy, it is challenging to differentiate the adjacent muscles, blood vessels and veins that closely surround the prostate gland. If these structures are damaged during the surgery, the patient may suffer from severe bleeding, urinary incontinence, rectal injury or erectile dysfunction.

Compared to open surgery and laparoscopic surgery, the Robotic surgical system provides a three-dimensional vision system that magnifies the surgical field up to 15 times and improves the ability of the surgeon to recognize and preserve vital tissues and remove only the prostatic tissue totally.

Robotic arms remain steady at all times and robotic wrists with seven degrees of movement, make it easier for surgeons to manipulate tissue and work from all kinds of angles and positions that surgeons would have difficulty reaching otherwise. Compared with open surgeries and laparoscopic surgery complications like bleeding, post-operative urinary incontinence, erectile dysfunction and margin positivity rates are very less in RARP. Patient recovery is faster, there is lesser hospital stay and better cosmetic results.

ROBOTIC PARTIAL NEPHRECTOMY FOR KIDNEY CANCER

Robotic Partial Nephrectomy is the treatment of choice for Kidney cancers of sizes up to 4 to 5cm. Partial Nephrectomy involves excision of the renal tumour and subsequent renorrhaphy (suturing of the kidney defect) while the renal artery is clamped and kidney blood flow is temporarily blocked. This step, therefore, needs to be performed within a certain time limit in order to avoid permanent renal injury. Traditional open partial nephrectomy involves large muscle-cutting abdominal or flank incisions that may involve rib removal and can have more bleeding, analgesic requirements, long hospital stays & recovery periods, and poor cosmetic outcomes. The main challenge with Laparoscopic partial nephrectomy is the difficulty to perform an effective renorrhaphy within a limited time period.

Compared to open or laparoscopic partial nephrectomy, robotic partial nephrectomy has the following advantages

• Lesser Bleeding
• Easier and more efficient renorrhaphy (Kidney Suturing) within the limited time period
• Better preservation of renal function
• Lesser analgesic requirements and early recovery
• Lesser Margin Positivity rates.

ROBOTIC-ASSISTED KIDNEY TRANSPLANT (RAKT)

Aster MIMS, Kozhikode is the only centre in North Kerala, and one of the few centres in India and the world doing Robotic Assisted Kidney Transplant (RAKT)

Advantages of RAKT includes:

• Smaller Incisions
• Lesser bleeding, the incidence of wound infection and analgesic needs
• Better cosmetic results
• Easier and efficient Vascular Anastomosis (due to 3D magnification and increased degree and range of motion of robotic arms)
• Lesser hospital stay and early return to normal activities.

ROBOTIC PYELOPLASTY FOR PELVIURETERIC JUNCTION OBSTRUCTION

Pelviureteric junction obstruction is one of the most common causes of hydronephrosis resulting from both congenital and acquired conditions. Pyeloplasty is the gold standard surgical treatment for the same. Laparoscopic pyeloplasty remains a challenging procedure and it requires high proficiency in laparoscopic skills especially due to the reconstructive part.

Compared to laparoscopic pyeloplasty, the advantages of robotic pyeloplasty includes:

• Easier and precise suturing
• The shorter learning curve for the surgeon
• Shorter operating time
• Faster recovery
• Better Cosmetic Result.

ROBOTIC RADICAL CYSTECTOMY FOR URINARY BLADDER CANCER

The gold standard treatment for muscle-invasive bladder cancer involves a radical cystectomy (removal of the urinary bladder), pelvic lymph node dissection(removal) and urinary diversion. Despite improvements in surgical techniques and hospital care, the open and laparoscopic radical cystectomy remains a highly morbid procedure with a reported morbidity and mortality of 50% and 5% respectively.

Advantages of Robotic radical cystectomy includes:

• Provides the surgeon with better visualization of the surgical site
• Easier to perform surgery in a more precise manner (with robotic arms) in the pelvic cavity, where the urinary bladder is located
• Lesser complication rates like bleeding, urine leakage, bowel injury and anastomotic leakage
• Decreased pain and shorter hospital stay.