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Robotic Surgery 1. Is Robot Surgery & Robot Assisted Surgery the same? Yes, #RobotAssistedSurgery is the correct technical term for the Surgery performed using a surgical robot, other terms being #RoboticSurgery 2. Does Robot perform surgery on its own? No, The robot is an intelligent machine where a computer and a special purpose software are integrated with surgical instruments. The computer needs orders & inputs from the Surgeons’ hands, whose movements are then replicated in the patient. 3. Is it a single machine? No, As opposed to Humanoid Robots which are a unibody Robots, the Surgical robots would usually have 3 parts – The Surgeon Console, The patient Cart and the Vision Cart. Its big enough to need a large room. 4. How is Robot Assisted Surgery different from #Laparoscopic Surgery? The instruments in Laparoscopic Surgery are handled directly by the surgeons with a limited range of movements & limited vision capabilities. A #SurgicalRobot allows far greater maneuverability and better vision to perform surgeries with great ease and unbelievable precision. 5. How is Robot Assisted Surgery beneficial then Laparoscopic Surgery? Due to better vision, improved ergonomics & matchless maneuverability surgeries which were considered difficult or nearly impossible with Laparoscopic Surgery are now very much possible & the conventional routine Laparoscopic Surgeries have become easier with better outcomes. 6. Which Surgeries are performed by #RoboticSurgery? Cavitatory Surgeries involving organs in the Abdomen & Chest are performed routinely. However Thyroid surgeries have been done trans orally. 7. What is the name of the Robot? The most famous and widely used surgical robot platform is #daVinciXi by #Intuitive Surgical is the latest version 8. How many cuts would I get in Robotic Surgery? Usually 3 or 4 cuts 8mm cuts would be needed for a robotic Surgery depending on the arms used. More than 4 cuts might be needed if additional assistant ports are used. 9. Since when are Robot Assisted Surgery being performed? Its been over 2 decades that Robotic surgeries are being performed. Safety & feasibility of this platform has been extensively studied & improvised to near-perfection. 10. How costly is Robotic Surgery? Robotic Surgery involves usage of disposable instruments with limited life. This makes the recurring cost of the robot a significant proportion of the expenses. One should expect a minimum of INR 1L (1300 USD) to INR 2L (2600 USD) above the conventional routine Laparoscopic Surgery cost.

Tele Medicine: Creating the Uber of Healthcare! Covid 19 pandemic induced cessation of routine life and services has affected everyone. The healthcare industry has been affected in a little weird way though, on one hand the pandemic is keeping Doctors super busy, with overwhelmed hospitals and on other hand the non-covid treating Doctor fraternity is idle. The readiness of doctors, availability of snappy internet, acceptance of online interactions and the currently idling healthcare system has fuelled an exponential rise in online platforms for easy connect with Doctors, especially in India. The platforms provide video, audio and text-based opinions and consultations by Doctors for a fee. It has grown into a race to become the Facebook-of-Healthcare, considering this is a multi-level revenue generating venture across the services – Laboratory Services, Radiology Services, Pharmacy, Nursing and Care-taker Services etc. All disruptive changes started with a beautiful intention at the outset – Facebook was supposed to be an interface for college students to interact and Amazon had intentions to just sell books. We know what these ventures have shaped up today. Telemedicine has been touted to help people in remote area, tide over the difficult times of social distancing and prevent crowding in hospitals. Give it few years and we’ll see what this grows into. Doctors and Patients are both venturing into an unknown and potentially dangerous territory. There are some uncomfortable truths deserving attention here. Issues are expected after the novelty factor fades and Tele-Medicine assumes a routine role. A privilege turning into service-on-demand kind of transformation – something we have started to witness. A Doctor search would match a product and service search, with rates and ratings being used to differentiate. Further when the convenience-addiction takes over, the decisions would narrow down to charges and availability. The available and cheaper option getting consumed higher and faster! Lack of in-person interaction and talking to screens may translate to over/complete reliance on Laboratory and Radiological Investigations – the only available and safe objective cues to rely on. Medical data have consistently shown that a good clinical examination and history can match and even augment results from investigations. However, the business-school trained health care industry leaders care less and are busy in capacity augmentation for “testing services” making the “human” component cheaper, at times free and almost frivolous. An addition to the worry is reduction of Medical Consultation to a Service A Doctor to a Provider! It’s pushing a serious Healthcare business to go the Shopping way – a traffic/herd like behaviour, algorithm dependant, SEO motivated and IT driven! Online interactions tend to be fluid and less dense. Internet has rarely succeeded in generating lasting bonds, even basic ones like friendship! A strong and a lasting Doctor-Patient relationship involves patience and time to develop. Online interactions fuel impatience and lack of faith with a tendency to Doctor Shop-Hop!

Robotic Hernia Surgery 1. Does the Robot perform the surgery on its own? No, the surgical robot is a sophisticated and an advanced instrument set-up with specially designed hardware & software making it “intelligent” but not “independent”. It needs the brain & the hands of the surgeon to help in the surgery. 2. Is Hernia Surgery possible with Robot? Yes, #RoboticSurgery is an Advanced form of #Laparoscopic Surgery where a specialized Robotic device is used to “assist” in the surgery performed by the Surgeon. Just like other Laparoscopic Surgeries got upgraded to Robotic platform, Hernia Surgery can also be performed safely & with better precision using the surgical robot. 3. How is #RoboticSurgery different than Laparoscopic Surgery? Laparoscopy uses long slender instruments with moving parts at the tip of the instrument that help in performing the surgical steps. However, the robotic ‘arms’ replicate the movements of human hands & arms, providing better and wider range of movements. This allows exact replication of the hand movements of the Surgeon in the patient. 4. How costly is #RoboticHerniaSurgery? As opposed to the instruments of Laparoscopic Surgery, which are reused till they malfunction, the instruments in robotic surgery are designed with predefined & limited shelf-life. The delicate moving parts and the need for precision necessitates usage of disposable instruments. This makes the Robotic Surgery platform premium as compared to Laparoscopic Surgery. The average addition to the surgery charges would be about 1L (1300 USD) to 2L (2600 USD) over and above the conventional charges. 5. Would #Mesh be still needed? Yes, as I mentioned above, Robotic surgery is an advanced Laparoscopic Surgery Platform to perform the surgery in a more precise fashion & with better ergonomics for the surgeon. The repair of hernia would need mesh-augmentation irrespective of the type of minimal access surgery – Laparoscopic or Robotic. 6. How many cuts are needed? Three/Four cuts would be needed to accommodate the camera system and the instrumentations. 7. Would my insurance cover it? Yes, it should. However, one must check the TPA & the sum-insured to avail the benefits. 8. Is #RoboticHerniaSurgery good for all the hernia repairs? Latest & advanced technology helps in delivering better cure & results for all surgeries, however this technology is costly. Laparoscopic Hernia Surgery can be an accepted modality for smaller hernia repair. 9. Would #RHS be less painful than Laparoscopic Hernia Repair RHS enables fixation of the mesh with sutures instead of tacking (Fixation with a screw) the mesh. This should translate to better pain relief. 10. Can Robotic Hernia Surgery be performed after #ProstateSurgery / #PelvicSurgery / #PreviousHerniaSurgery / #RecurrentHerniaSurgery? Yes. As a matter of fact, the robotic platform has distinct advantages in these very situations where the Laparoscopic platform may have limitations. Better 3D vision, finer & precise movements & maneuverability allows extremely-difficult-to-operate case with minimal invasive surgery.

Robotic TARUP / Robotic TARM Robotic TARUP (Trans Abdominal Retro-muscular Umbilical Prosthesis) or the TARM (Trans Abdominal Retro-muscular Meshplasty) is a term for a Robotic Hernia repair. In this surgery a surgical Robot is used in an intra-abdominal approach and the mesh is placed behind the rectus abdominis muscle by creating a retro-muscular space and lowering the posterior rectus sheath-peritoneum complex. Thus the mesh gets sandwiched in between the layers of the abdominal wall resulting in a stronger repair as compared to an onlay or a sublay technique. The end result is a mesh that is extra-peritoneal leaving the intestines and other organs undisturbed. Usage of Surgical robot allows a HD-3D vision with magnification, a tremor-free instrument control with very high degree of precision. The robotic arms allow secure and a strong closure of the hernial defect/s. The robotic surgery is cost effective as it mitigates usage of a very costly dual-layered mesh and any fixation device. For primary & recurrent ventral / umbilical / epigastric hernia Robotic TARUP / Robotic TARM is now a preferred procedure. If you are suffering from any of such hernia or have been adviced a surgery for same kindly visit us for an opinion. For surgery details you can visit the link mentioned below. Robotic TARUP / TARM Video #RoboticTARUP #RoboticTARM #RoboticVentralHerniaSurgery #RoboticVentralHerniaRepair #RoboticHerniaSurgery #DrVishalSoni #DaVinciXi #Hernia #Meshplasty #HerniaSurgery

Care after Hernia Surgery In Hospital 1. You would be allowed sips of water about 2 hours after surgery, followed by Liquids / Soft diet as per post op orders 2. The urine catheter will be removed next morning. There would be sensation of wanting to pass urine due to the catheter bulb, it is expected. 3. You might feel sleepy for upto 6 hours after surgery due to post-anesthesia effect. 4. Some Nausea is expected for upto 6 hours after the surgery, You would be given medicines for the same.  5. Having dry throat & throat irritation is common, it is a temporary event due to anesthesia and should maximally last till night. Hot tea / soup, lozenges, steam inhalation & voice rest help. 6. You would be given adequate pain relief injections for comfort. Kindly ask for additional dose, if severe pain/Inability to sleep. 7. In case of Spinal anesthesia sudden onset of pain might occur when the effect wears off, don’t be alarmed. Additional painkiller can be demanded & would be given to make you comfortable. 8. You should be allowed to sleep on right or left side positions / turning in bed once the effect of Anaesthesia wears off. Usage of a pillow below the knees help in decreasing the abdominal pain and discomfort. 9. In case of spinal anesthesia, you would be allowed to walk next morning, In case of general anesthesia, you can start walking once comfortable. 10. It is advised to avoid visiting washroom & straining to poop till next day morning. It is advised to not be on the commode for more than 5 mins at a stretch & the door not be latched. 11. Bathing should be allowed from next morning, the dressings would normally be water-proof. 12. There might be some residual swelling at Hernia Site, it should decrease in next 3-7days 13. If the pain/ discomfort is better, expect the discharge late in evening or next morning. Care At home 1. Blood sugars & Blood Pressure are expected to be deranged (High or Low) for a day or two after surgery & shouldn’t be seen as a panic situation. 2. No individual food / food product restrictions are applicable with respect to the Surgery, however medical-based restrictions would continue. 3. Walking is allowed & encouraged, Atleast 30 mins per day, once pain & swelling have decreased. 4. Usage of Western Style washroom with a foot rest is recommended. 5. Usage of Scrotal Support / Abdominal Binder / Pressure dressings would be explained to you. Use it all the times except while sleeping. 6. Avoid straining or lifting heavy weights (>5kgs), participation in contact sports, riding two-wheeler, squatting on floor, sitting on floor crossed legged, excessive forward bending for atleast 6 weeks post-surgery. 7. Promptly seek medical help for any issues with Constipation, Urinary issues or Coughing. This can interfere with Mesh. 8. Follow-up is usually after 7 days. Ordinarily no change of dressing is needed. 9. Kindly keep a copy of discharge card safely with you all the time with details of the Surgery and the type of Mesh used. 10. Strictly avoid smoking for atleast 3 months after surgery. 11. For females, avoid planning pregnancy for atleast 1 year post surgery This is a non exhaustive list of points for care after hernia surgery. These are standard set of instructions for our patients operated by Robotic or Laparoscopic method for Hernia Surgery “Wish you a healthy & an uneventful recovery”   #DrVishalSoni #ZydusHospitals #PatchOfHappyness   #RoboticHerniaSurgery #LaparoscopicHerniaSurgery #HerniaSurgery #Hernioplasty #Mesh #Hernia #HerniaRepair #MinimallyInvasiveHerniaSurgery #InguinalHernia #GroinHernia #FemoralHernia #SpigelianHernia #IncisionalHernia #RecurrentHernia #UmbilicalHernia #ParaUmbilicalHernia   

Robotic Cholecystectomy – Is it best for you? Robotic Cholecystectomy is a surgical procedure involving removal of the gallbladder with the help of a surgical robotic system. Traditionally, gallbladder removal surgery, has been done through a large incision in the abdomen. With Robotic Cholecystectomy, the surgery is performed through small incisions with the help of a surgical robotic system – in our case Da Vinci Xi by Intuitive Surgicals. The robotic system consists of a console where the surgeon sits and controls the robotic arms. It is like the cockpit of a plane. The Robotic arms hold the surgical instruments and a camera that provides a magnified HD-3D view of the inside of the body. he robotic platform uses a special vision assist system called Firefly Mode which uses Infra-red spectrum of the light to identify the biliary structures and the blood vessels. Prior to the surgery a special dye (colored compound) called Indocyanine Green (ICG) is injected into the vein. The dye gets preferentially accumulated in the Gall bladder & the Bile ducts, thus helping in identification and safe surgery due to florescent shade. f you are considering this procedure, talk to your Robotic Surgeon to see if it is the right option for you. Talk to us to know more. You can visit our youtube channel for Gall bladder Surgery videos here.  https://www.youtube.com/channel/UCQux7wdprh5fG-zm1IQYlvw       #DrVishalSoni #RoboticCholecystectomy #RoboticSurgery #Cholecystectomy #GallStones #GallBladder #Cholelithiasis #Cholecystitis Lorem ipsum dolor sit amet, consectetur adipiscing elit. Ut elit tellus, luctus nec ullamcorper mattis, pulvinar dapibus leo.

Surgery for Recurrent Hernia Recurrent hernias can be more challenging to treat, and surgical repair is often required. In this blog post, we will discuss recurrent hernia surgery, including what it is, how it is performed, and what to expect during recovery. What is Recurrent Hernia Surgery? Recurrent Hernia Surgery is a procedure performed when a hernia reoccurs after a previous surgery. Hernia recurrence can happen for various reasons, such as improper technique during the initial surgery, inadequate healing, or a failure of the mesh used to support the weakened tissue. During recurrent hernia surgery, the surgeon will identify the cause of the recurrence and repair the hernia using a variety of techniques, including suturing the weakened tissue, reinforcing the area with mesh, or a combination of both. How is Recurrent Hernia Surgery Performed? Recurrent hernia surgery is typically performed under general anesthesia. The surgeon will make an incision at the site of the previous hernia repair in Open Approach, allowing them to access the area of the recurrence. The surgeon will then carefully examine the area and identify the cause of the recurrence. If the previous mesh has failed, they will remove it and replace it with a new mesh. If the weakened tissue is the cause of the recurrence, the surgeon will suture it to strengthen the area. Once the repair is complete, the surgeon will close the incision with stitches or staples and cover it with a dressing. What to Expect During Recovery? Recovery from recurrent hernia surgery can take several days to weeks, depending on the extent of the surgery and the individual’s overall health. Immediately after the surgery, the patient will need to rest and avoid strenuous activity for several days. Pain and discomfort are common after surgery and can be managed with over-the-counter pain medications or prescribed pain relievers. The patient may also experience swelling, bruising, or redness at the incision site. The team will provide specific instructions on caring for the incision, including keeping it clean and dry and changing the dressing as needed. The patient will also need to avoid lifting heavy objects or participating in unaccustomed strenuous activities until cleared by the surgeon. It is essential to follow the surgeon’s instructions carefully to ensure a smooth recovery and prevent further complications. In conclusion, recurrent hernias can be a challenging condition to manage, but surgery is often an effective treatment option. Recurrent hernia surgery involves repairing the hernia site after a previous surgical repair has failed. The procedure is typically performed under general anesthesia, and recovery can take several weeks or months. It is essential to follow the surgeon’s instructions carefully to ensure a smooth recovery and prevent further complications.       #RecurrentHernia #Hernia #Meshplasty #Mesh #HerniaSurgery

Robotic Surgery Training in India Robotic surgery is a cutting-edge technology that has revolutionized the field of surgery in recent years. The use of robotics has made surgical procedures more precise, less invasive, and faster, resulting in better outcomes for patients. However, to be able to perform robotic surgery, surgeons need to undergo specialized & supervised training.  #RoboticSurgeryTraining involves learning how to operate a robotic surgical system, such as the Da Vinci Surgical System, which is one of the most popular robotic surgical systems used today. We have a tailored modular training program for Robotic Surgery Training at Zydus Hospitals, Ahmedabad, Gujarat, Bharat. More details can be found here. The course director Dr Vishal Soni is an Expert Robotic Surgeon and a Proctor with Intuitive Surgicals. He has done phenomenal work in the field of Robotics in Benign Gastroenterology and has been invited to more than 15 events for sharing his domain expertise. He has Proctored over 55 surgeons in India and runs one of the most successful Robotic Surgery Programs for Benign Gastro-Intestinal Surgery. Robotic Surgery training is divided into three stages: didactic training, simulation training, and hands-on training. Stage 1: Didactic Training Didactic training is the first stage of robotic surgery training. It involves learning the theoretical aspects of robotic surgery, including the basic principles of robotics, the relevant speciality-specific anatomy and physiology and the principles of surgical techniques. Surgeons receive didactic training in several ways, including attending lectures, reading textbooks, P2P sessions and watching videos. Didactic training is important as it provides the foundation for the other two stages of robotic surgery training. Stage 2: Simulation Training Simulation training is the second stage of robotic surgery training. It involves using a ‘simulator’ to practice robotic surgery procedures. The simulator creates a virtual replica of the environment where Da Vinci Surgical System is put to use. It allows surgeons to practice different surgical steps such as suturing, cutting, and manipulating tissue. Simulation training is important as it allows surgeons to develop their skills in a safe and controlled environment. Surgeons can make mistakes without putting patients at risk, and they can receive immediate feedback on their performance. Simulation training can be done individually or in pairs and it can be customized to meet the needs of an individual surgeons. Stage 3: Hands-on Training Hands-on training is the third and final stage of robotic surgery training. It involves working with a mentor to perform robotic surgery procedures on patients. Surgeons are supervised by experienced robotic surgeons, who provide guidance and feedback throughout the procedure. Hands-on training is important as it allows surgeons to apply the skills they have learned in the first two stages of training to real patients. Surgeons learn how to manage the robotic surgical system, how to position the instruments, and how to communicate with the surgical team. Robotic surgery training is essential for surgeons who want to perform robotic surgery procedures. The training involves three stages: didactic training, simulation training, and hands-on training. Didactic training provides the theoretical foundation for robotic surgery, simulation training allows surgeons to practice their skills in a safe environment, and hands-on training allows surgeons to apply their skills to real patients. By undergoing robotic surgery training, surgeons can provide better outcomes for their patients and stay at the forefront of surgical technology. We are one of the only centers with a comprehensive hands-on course for Robotic Surgery Training in India. Contact us for more details on drvishalsoni@gmail.com.

Incisional Hernia Surgery is a procedure performed to repair a hernia that occurs at the site of a previous surgical incision. A hernia is a medical condition where an organ or tissue bulges through a weak spot in the surrounding muscle or tissue. Incisional hernias usually occur after a surgical incision has weakened the abdominal muscles, and the bulge can appear days, months, or even years after the surgery Surgery is the only treatment for incisional hernias. If left untreated, they can become larger and cause significant discomfort, pain, and complications. Incisional hernia surgery aims to repair the weakened muscles and tissues, preventing the hernia from recurring. In this blog, we will discuss incisional hernia surgery in detail. Types of Incisional Hernia Surgery There are two main types of incisional hernia surgery: open surgery and laparoscopic surgery. Open Surgery: In open surgery, a single incision is made in the abdomen, and the hernia is repaired through this incision. The surgeon will first push the bulging tissue or organ back into the abdominal cavity, and then the weakened area is reinforced with a mesh or sutures. The incision is then closed with sutures or staples. Open surgery is more invasive than laparoscopic surgery and requires a longer recovery time. Robotic/Laparoscopic Surgery: Robotic/Laparoscopic surgery is a minimally invasive procedure where several small incisions are made in the abdomen, and a laparoscope (a thin, flexible tube with a camera and light) is inserted into one of the incisions. The surgeon uses specialized surgical tools to repair the hernia through the other incisions. A mesh is used to reinforce the weakened area, and the incisions are closed with sutures or staples. Robotic and Laparoscopic surgery are less invasive than open surgery and requires a shorter recovery time. Recovery from Incisional Hernia Surgery The recovery time after incisional hernia surgery depends on the type of surgery performed, the size of the hernia, and the patient’s overall health. In general, patients can expect to be discharged from the hospital within a few days of the surgery. After surgery, patients may experience pain, swelling, and bruising around the incision site. Pain medication may be prescribed to manage these symptoms. Patients are advised to avoid strenuous activity and heavy lifting for several weeks following surgery to allow the incision to heal properly. Complications of Incisional Hernia Surgery Like any surgical procedure, incisional hernia surgery carries a risk of complications. Some potential complications include infection, bleeding, blood clots, damage to surrounding organs, and hernia recurrence. However, with proper care and follow-up, the risk of complications can be minimized. Incisional hernia surgery is a safe and effective treatment for repairing a hernia that occurs at the site of a previous surgical incision. Open surgery and Robotic/Laparoscopic surgery are the two main types of incisional hernia surgery. Both procedures aim to repair the weakened abdominal muscles and tissues, preventing the hernia from recurring. While recovery time and potential complications may vary, incisional hernia surgery is generally a successful procedure with a high success rate. If you are experiencing symptoms of an incisional hernia, it is important to seek an expert opinion about your treatment options.     #DrVishalSoni #IncisionalHerniaSurgery #Hernia #HerniaSurgery #RoboticSurgery #LaparoscopicSurgery #Mesh #Meshplasty #Hernioplasty #HerniaRepair #DaVinci #DaVinciXi #RobotAssistedSurgery #RoboticIncisonalHerniaSurgery     

Robotic Hernia Surgery Robotic Hernia Surgery is a minimally invasive surgical procedure that uses a robotic system to repair hernias. A hernia is a condition in which an organ or tissue protrudes through a weak spot in the muscle or tissue that surrounds it. Hernias can occur in various parts of the body, including the abdomen, groin, and diaphragm. We perform Robotic hernia surgery using the most advanced da Vinci surgical system by Intuitive Surgical, which is a computer-assisted system that allows the surgeon to operate with unmatched precision and control. The system consists of a console that the surgeon uses to control the robotic arms, which are equipped with surgical instruments. During the procedure, small incisions are made on the abdomen through which the robotic “arms” and a camera are inserted. We use the surgeon console to control the robotic arms and perform the repair. The camera provides a high-definition 3D view of the surgical area, allowing us to see the area more clearly than with traditional open/laparoscopic surgery. The benefits of robotic hernia surgery include less pain and scarring, faster recovery time, and a lower risk of complications such as infection and bleeding. Robotic surgery also allows the surgeon to perform more complex procedures with greater precision, reducing the risk of damage to surrounding tissue and organs. Robotic hernia surgery may not be suitable for everyone and the decision to undergo this procedure should be made in consultation with a qualified surgeon. Patients with certain medical conditions or previous surgeries may not be candidates for robotic surgery. Dr Vishal Soni is an Expert Robotic Surgeon & one of the few Proctors in India with Intuitive Surgicals. He is a master in Hernia & Abdominal Wall Reconstruction Surgeries. He can be consulted at Zydus Hospitals for Opinion & Surgery.     #Hernia #AbdominalWallReconstruction #RoboticSurgery #RobotAssistedSurgery #RoboticHerniaSurgery #HerniaSurgery #Robot #DaVinci #DaVinciX #DaVinciXi