In a first, handball size tumor removed using robotic surgery
29 Jan 2013 11:54 PM GMT
As of now, across the globe only 5 x 3 cm-long tumors have been reported to be successfully removed through laparoscopic surgery, but one of the largest tumors (handball size) has been treated and successfully removed from a human body through robotic surgery for the first time in history of medical science. This surgery was lead by a team of 10 surgeons at the Department of Minimal Access, Metabolic and Bariatric Surgery, Sir Ganga Ram Hospital.
Earlier, such tumors have been operated but only through conventional laparoscopic surgery, which had certain complications after the surgery.
There are a very few case reports of retro peritoneal tumor extraction using robotic technique. Dr Vivek Bindal, laparoscopic consultant Bariatric and Robotic Surgeon at Sir Ganga Ram Hospital said, ‘To the best of our knowledge, there is only one case report of robot-assisted resection of a retroperitoneal schwannoma (tumor). The 45 -year-old lady hailed from Haryana from a lower middle class family. Her treatment expenses to the tune of Rs 1.25 lakh were sponsored by the Haryana government.
The patient developed the symptoms of retroperitoneal scwannoma (tumor) like complaints of heaviness in right side of abdomen. Further there was hypohydrosis of right lower limb for two years. Abdominal CT and MRI revealed 13 x 9 x 7 cm cm well defined rounded heterogeneous enhancing mass, moreover, she had pain in the right leg, less of sweating which in medical terms is known as hypohydrosis.’
The use of robotics gives certain advantages over laparoscopic surgery such as 3D vision, endowristed instruments with seven degrees of freedom (as compared to five degrees of freedom in laparoscopic surgery, motion scaling, tremor filtration and ergonomic comfort for the surgeon. These advantages help in performing a minimally invasive surgery even for large retroperitoneal tumors.
Dr Praveen Bhatia, senior consultant and chairperson of Minimal Access and Bariatric Surgery Centre at Sir Ganga Ram Hospital said, ‘It was a very sensitive surgery which removed one of the largest tumor being diagnosed so far which was 13 x 9 x 7 cm long. The tumor was stuck to the liver, pancreas, Small Intestine and Large Intestine as well. The lump was just in the middle of the right kidney and the main blood vessel. This tumor was excised using Robotic surgery to provide advantage of less complications to the patient after the surgery.’
‘Robotic surgery is a three dimensional vision surgery where there are more degrees of freedom of instruments as there are certain places inside the human body where hands cannot reach in that case the robotic arms helps the surgeon to reach out to those areas which needs to be operated. This kind of surgery acts as an advantage to the patient as it is a safe and effective technique and there are less scars on the skin and less blood loss’, he said.
Adding further, he said ‘She underwent a robot assisted extraction of the tumor using three robotic arms. The patient was discharged on third post-operative day and is doing well on 1 month follow up. Retroperitoneal schwannoma is a rare tumor which occur in females between 2nd to 5th decade of life. This lump usually do not exceed a diameter of 5 to 6 cm, but larger tumors have been reported. Complete surgical excision is the mainstay of therapy.’
Dr Bindal said, ‘It was a two-hour surgery including robotic docking time of 10 minutes. Blood loss was around 200 ml. There are no pre-operative or post-operative complications and the patient was discharged on the third day after the operation and is now doing well’.
Earlier, such tumors have been operated but only through conventional laparoscopic surgery, which had certain complications after the surgery.
There are a very few case reports of retro peritoneal tumor extraction using robotic technique. Dr Vivek Bindal, laparoscopic consultant Bariatric and Robotic Surgeon at Sir Ganga Ram Hospital said, ‘To the best of our knowledge, there is only one case report of robot-assisted resection of a retroperitoneal schwannoma (tumor). The 45 -year-old lady hailed from Haryana from a lower middle class family. Her treatment expenses to the tune of Rs 1.25 lakh were sponsored by the Haryana government.
The patient developed the symptoms of retroperitoneal scwannoma (tumor) like complaints of heaviness in right side of abdomen. Further there was hypohydrosis of right lower limb for two years. Abdominal CT and MRI revealed 13 x 9 x 7 cm cm well defined rounded heterogeneous enhancing mass, moreover, she had pain in the right leg, less of sweating which in medical terms is known as hypohydrosis.’
The use of robotics gives certain advantages over laparoscopic surgery such as 3D vision, endowristed instruments with seven degrees of freedom (as compared to five degrees of freedom in laparoscopic surgery, motion scaling, tremor filtration and ergonomic comfort for the surgeon. These advantages help in performing a minimally invasive surgery even for large retroperitoneal tumors.
Dr Praveen Bhatia, senior consultant and chairperson of Minimal Access and Bariatric Surgery Centre at Sir Ganga Ram Hospital said, ‘It was a very sensitive surgery which removed one of the largest tumor being diagnosed so far which was 13 x 9 x 7 cm long. The tumor was stuck to the liver, pancreas, Small Intestine and Large Intestine as well. The lump was just in the middle of the right kidney and the main blood vessel. This tumor was excised using Robotic surgery to provide advantage of less complications to the patient after the surgery.’
‘Robotic surgery is a three dimensional vision surgery where there are more degrees of freedom of instruments as there are certain places inside the human body where hands cannot reach in that case the robotic arms helps the surgeon to reach out to those areas which needs to be operated. This kind of surgery acts as an advantage to the patient as it is a safe and effective technique and there are less scars on the skin and less blood loss’, he said.
Adding further, he said ‘She underwent a robot assisted extraction of the tumor using three robotic arms. The patient was discharged on third post-operative day and is doing well on 1 month follow up. Retroperitoneal schwannoma is a rare tumor which occur in females between 2nd to 5th decade of life. This lump usually do not exceed a diameter of 5 to 6 cm, but larger tumors have been reported. Complete surgical excision is the mainstay of therapy.’
Dr Bindal said, ‘It was a two-hour surgery including robotic docking time of 10 minutes. Blood loss was around 200 ml. There are no pre-operative or post-operative complications and the patient was discharged on the third day after the operation and is now doing well’.
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