Hospitals turn to robots to clear backlog of elective surgeries amid covid-19

Though RAS (robotic assisted surgeries) has been around for many years, the usage has been sporadic. Post covid-19, the fear of crowded spaces and higher risk of infection due to prolonged stays in hospitals is making patients seek out robotic surgeries as an alternative to traditional open surgeries.

“After the pandemic, we have been seeing an increase in demand for robotic surgery as the procedure allows for social distancing with lesser people around the patient and robot. The infection rates are lower as compared to laparoscopy and open surgeries," said Amol Kumar Patil, consultant, Robotic Surgery & Urology, Apollo Hospitals, Navi Mumbai.

In March, the ministry of health and family welfare issued an advisory, urging hospitals across the country to put all non-essential elective surgeries on hold. This led to a backlog of surgeries. CovidSurg Collaborative, an international research consortium, has estimated that 5,05,800 elective surgeries including 51,100 cancer surgeries and 27,700 obstetric surgeries were delayed or cancelled in India due to the imposition of lockdown and fear of infection.

“There is a sense of fear among patients to get treatment at hospitals. They are resisting treatment that involves any physical contact with surgeons and that requires longer hospital stays after surgery," said Avanish Saklani, professor robotic/colorectal MS, FRCS, Tata Memorial Hospital, Mumbai.

Traditional surgeries involve a large team of doctors that have to operate for long hours and use hundreds instruments for the completion of one surgery.

“Due to the invasive cutting of the wound and excessive bleeding, the patient might develop post-surgery infections leading to higher risk of contracting the virus," said Somashekhar S P, chairman & HOD Surgical Oncology, MHEPL.

Somashekhar explains, to avoid further backlog of surgeries, SAGE and Associations of Robotic consortium discussed new methods of conducting surgeries in the new covid-19 era. They compared traditional methods of surgery to robotic-assisted surgery and found that robotics had several benefits that were proving to be beneficial during covid-19.

For instance, RAS involves just 4 instruments and a very small team of medical professionals in the operating room. The procedure is also less painful and causes less blood loss as the wound is just few millimetres in the subcuticular. Patients recover faster from the surgery, leading to early discharge.

Somasekar points out, robotic surgeries are also more convenient for doctors and allows them to perform many surgeries in a single day without feeling fatigued. The surgeries are performed by robotic arms are controlled by a doctor sitting at a remote console with access to 12 times magnified 3D view of the surgery.

“During the initial days of the lockdown, people were avoiding surgeries, but now it is picking pace. As of now, 60% of the surgeries we are doing is through robotics," said Sudhir Kumar Rawal, director – Surgical Oncology, Rajiv Gandhi Cancer Institute.