Robotic surgery and some thoughts

             Robotic cholecystectomy was going on. Surgeon was uncomfortable because he was not able to use the Maryland dissector the way he wanted to. Using the Bipolar cautery he was not able to adequately separate the tissue. My junior scrubbed and assisting by the patient side suggested that we should use scissors to cut the tissue. Then the Urology professor watching the procedure replied, “we can, but we will have to open a new instrument and that will add cost to the surgery”. We were doing robotic cholecystectomy as a part of getting used to the robot before going on to do major surgeries.

              Definitely robotic cholecystectomy does not offer any advantage over laparoscopic surgery. But in fact, add cost and effort. The machine itself costs hefty and the accessories also come at a high cost. Each surgery needs costly drapes and the instruments get auto-locked after ten uses. The Da Vinci system has got the monopoly over robotic surgery all over the world. 

             The day before the surgery I went to the patient to take consent for the surgery. Earlier she was posted for Laparoscopic cholecystectomy, but the surgery was cancelled since the previous cases on the list got delayed and the OT time was over. I explained to her that we were planning for a robotic surgery and if there was any problem, we will convert it into a normal laparoscopic procedure and again if we find difficulty, we may have to convert it to an open surgery. The poor patient coming from a village hundreds of kilometers away nodded her head for what ever I explained to her. Finally her only question was “Do I have to stay fasting (NPO), tomorrow also?”