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          New Delhi, May 21 (IANS) Four finger-tip sized incisions, four   robotic arms, including a camera eye snaking inside, the magnified image of the   visceral organs being watched on a screen outside as the surgical instrument arm   moves deftly to remove the tumour or blockage. Minimal blood loss, no long   hospital stay -- welcome to the revolutionary world of robotic surgery that is   gaining in popularity in India.
 |  Some of the major hospitals in the capital, including the All India Institute of   Medical Sciences (AIIMS), are performing complex surgeries the robotic   way.
 Major procedures such as removal of tumours, heart surgery and   gynaecological surgery that would traditionally require the scalpel to make   large and deep cuts in the body and consequent blood loss are now being done   with robotic arms.
 
 "Robotic surgery allows us to do many complex   operations that would require large incisions," Sudhir Srivastava, chairman, CEO   and managing director, Fortis Healthcare International Centre for Robotic   Surgery in New Delhi, told IANS.
 
 Srivastava said conventional cardiac   surgery requires splitting of the sternum, but in robotic surgery, using a   robotic surgical system called Da Vinc, just four-five finger-tip sized   incisions are all it requires.
 
 "The tips of the robotic arms behave like   human wrists and allows us to do complex surgeries through tiny holes," he   said.
 
 The camera arm of the robot allows surgeons to see inside the body   in 3D. The image of the internal organs -- magnified up to 10 times in high   definition -- shows up on a screen at the surgeon's console. Using hand and foot   controls, the surgeon directs the robotic arms with the surgical tools to   perform the required procedure.
 
 "The camera acts as the eyes, while the   instruments act as the arms of the surgeon," said Srivastava, adding that the   surgery is "very precise, the incisions are tiny, there is little trauma and the   patient can return home in a day or two. There are less complications, less   blood transfusion and it is cosmetically preferable".
 
 What about the   cost?
 
 The cost varies between Rs.60,000 and Rs.1.5 lakh (approx   $1,000-$2,700), depending on the procedure, he says.
 
 "It works out more   expensive than the conventional surgery, but the benefits are huge because of   all the advantages," Srivastava said.
 
 He says the cost is due to the   technology, as each machine costs about Rs.8-10 crore (approx $1.4-1.8 million),   depending on the model.
 
 He says that robotic surgeries abroad are "10   times more expensive".
 
 Fortis has two robotic systems and the hospital   performs cardiac, thoracic, urology, gynaecology, general, head and neck and   orthopaedics procedures.
 
 At AIIMS, robotic surgery is done in the field   of urology, ENT cardiac, thoracic and in general surgery, says P.N. Dogra,   professor and head of the Department of Urology, adding that the urology section   gets around 130-140 patients every month.
 
 But AIIMS does not charge   anything from general patients. "During the hospital stay, even the meal charge   is not taken from some patients," Dogra said.
 
 One major advantage of the   robotic system, he says, is the "tremor filtration" in which the "unintentional   movement of the doctor is not carried over to the patients during the operation   as the doctors are behind the operation table monitoring the   robot".
 
 Arvind Kumar, a former professor of surgery at AIIMS, who is now   heading the Institute of Robotic Surgery at Sir Gangaram Hospital, says the   hospital performed "Asia' first vascular surgery" using the robotic   system.
 
 Explaining the high costs, Kumar says the robotic technology is   in evolution. "As its uses become more, the prices will crash, like in the case   of mobiles," Kumar told IANS.
 
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