Cost-effective Healthcare of International Standards now in India

Dr. Srivastava’s brief introduction
Dr. Sudhir P. Srivastava has performed over 1300 robotic cardiothoracic procedures — the largest volume in the world. He is the only doctor in the world to have performed a Quadruple Vessel Beating Heart TECAB (Totally Endoscopic Coronary Artery Bypass) Surgery even though at the University of Chicago in 2007. He has also carried out numerous ‘first ever’ complex cardiac procedures in India since November 2011. These very first time operations in India have been: Robotic Single Vessel Beating Heart TECAB, Robotic Double Vessel beating Heart TECAB, Robotic Myxoma Excision and many other hybrid circumstances. These days he is the only cardiothoracic surgeon in India who performs Totally Endoscopic Coronary Artery Bypass on a beating heart.

The name ‘Robotic Surgery’ seems to suggest that the process is being performed by a robot…

The name has stuck, but it’s truly a misnomer. To get in touch with it ‘Robot-Assisted Surgery’ would be far more suitable. The robotic surgical system serves as an instrument for surgeons, enabling them to be much more precise, advancing their technique and enhancing their capability in performing complicated minimally invasive surgery. The da Vinci System replicates the surgeon’s movements in genuine time. It can not carry out any sort of surgical manoeuvre without having the surgeon’s handle.

How is robotic surgery much more beneficial for sufferers?

As opposed to traditional methods of performing surgery, robot-assisted surgery is minimally invasive which indicates smaller incisions of 1-2 cm only as compared to traditional surgery exactly where the physique is opened to access the operative field with a ten-12 cm cut. Minimally invasive surgery benefits in lesser pain &amp trauma, lesser blood loss, more rapidly recovery time &amp minimal scarring. In fact we send the patient residence in three-5 days. The procedure becomes less daunting for old and young alike. Taking into account all these aspects, robotic surgery has seen tremendous development and acceptance in the Western World providing rise to numerous benefits for the patient.

In laparoscopic surgery also smaller cuts are made rather of big cuts. Then how is Robotic Surgery different from laparoscopic and endoscopic procedures?

Robotic Surgery makes it possible for surgeons to execute complicated surgical procedures that might not be feasible via laparoscopic/endoscopic choices. In Robotic Surgery, a surgeon gets a 3D vision of the area that has to be operated upon, and that also magnified up to 10 instances far more. The instruments we use can be moved the way we move our wrist and there is no tremor while performing the operation. Laparoscopic procedures, on the other hand, offer you surgeons only 2D vision long instruments with no wrist-like motion and no tremor filtration.

Which medical procedures can be performed employing robotic help?
Robotic Surgery can be performed for the following specialities: cardiac, thoracic, urology, gynaecology, basic, head &amp neck, orthopaedics and ENT.

What could be the difference in cost in between a surgery performed in traditional strategy and a single making use of a robot and will my well being insurance coverage pay for it?

The price of Robotic Surgery is 30-40% greater than traditional surgery. Nevertheless, with the benefits presented by Robotic Surgery including minimal rehabilitation, significantly less personal trauma/ side effects &amp early return to perform, in the finish it is all round less pricey. The individuals who have currently opted for this surgical choice counter that robotic surgery actually proves to be less expensive general – from the point of view of the lowered hospital bill and speedy return to an active, productive life. Also, Robotic surgery is billed as Minimally Invasive Surgery &amp consequently, is covered by well being insurance coverage.

What are the aspects stopping Robotic Surgery from being integrated into healthcare procedures at a more rapidly pace?

High initial capital charges and high fees of robotic consumables add to the cost of each and every case. There is a steep studying curve for surgeons and operating space teams. The perfect requirement at this time involves surgeons with 8-10 years of operative knowledge and commitment on portion of operating room teams. A lot of surgeons never want to go via the understanding curve, longer operative time and possible distinct outcomes in the middle of their surgical careers. Like any new method and procedure, initially there is lack of awareness amongst physicians and patient neighborhood that leads to slower adoption. Nevertheless, when institutions and surgeons have committed themselves to robotic technology, the adoption has been significantly faster as witnessed by the international development of robotic surgery procedures. The quantity of robotic systems in India has enhanced from 14 to 22 in a year which means that individuals are becoming conscious and there is an enhance in demand for robotic surgery. However, the dilemma in India remains lack of talent in robotic surgery, and surgeons being capable of using such technology and delivering the necessary outcomes. There has been no tension by the significant medical service providers to bridge this gap. We at ICRS intend to alter this strategy and make robotic surgery an attainable reality for any doctor willing to commit the time to find out these tactics.

You are the Chairman-MD of ICRS (International Centre for Robotic Surgery). What is ICRS all about?

To give you a background, I have been based in the US because the 70s, and was practising there. I have launched robotic surgical programmes in a number of countries like Australia, Korea, China, Thailand and Japan. But it has always been a dream for me to provide my service by means of medicine to India. Throughout my evolution as a surgeon, I was continuously teaching fellow colleagues in India, and in 2002, I performed the initial robotic surgery in the subcontinent. Because then, I have hosted many Indian surgeons back in the US who have been enthusiastic about coaching. But in order for the programmes to flourish in India, and to utilise the full talents of a lot of gifted Indian surgeons, there had to be somebody on the ground to additional mature their education. In 2010, I set up ICRS in India to supply the most advanced surgical practices to patients in the Indian subcontinent, and to also teach and train surgeons. ICRS is the only centre in India providing a complete robotic surgery plan. The ICRS consulting group consists of 20 world leaders in the fields of minimally invasive and robotic surgery specialising in Cardiac, Thoracic, Urology, Gynaecology, Common Surgery, Head and Neck and Orthopaedics. The combined robotic surgery knowledge of these surgeons is more than 15,000 instances — the biggest collective volume in the globe.

ICRS has collaborated with Fortis Healthcare to supply onsite surgical knowledge to the Fortis network of hospitals. On November 2nd 2012, the 1st robotic surgery centre was launched at Fortis Escorts Heart Institute, New Delhi. Fortis ICRS centres will be set up across Fortis hospitals in Mumbai, Gurgaon, Bangalore, Chennai, Kolkata as effectively as some tier II cities like Mohali and Jaipur. Fortis ICRS is a huge step forward towards commitment to delivering the most recent in healthcare in terms of cutting-edge technology and greatest-in-class health-related expertise. The centres will undoubtedly set new paradigm in robotic surgery in India.

ICRS has also collaborated with Asian Heart Institute ‘India’s Highest Accredited Hospital’ and ‘The Best Private Cardiac Hospital'( as per a CNBC and The Week survey completed in 2011) to offer experience and service in robotic cardiovascular surgery in Mumbai and Western India .

My vision is to establish extensive robotic surgery program here in India, establishing and nurturing talent to make this a longer term reality, and conducting educational forums and seminars to educate the mass on the positive aspects and outcomes of such a plan.

What can developments in this field imply to the country?

Right now, robotic surgery is not regarded as experimental as very mature applications are now obtainable planet-wide. Robotic surgery has been practiced for the last 12 years worldwide. Last year around 350,000 robotic procedures were performed globally. Improvement in this field would mean a lot of a lot more individuals can advantage in India utilising this method. This will further be a boon to the health-related tourism sector in India.
India was one of the initial nations to recognize the prospective of health-related tourism and right now is the top destination for worldwide medical tourists. Currently in 2004, India has received 150,000 health-related vacationers and this quantity has grown by an impressive 33% by 2008 to 200,000 inbound healthcare tourists. It is estimated that by the year 2015, India will acquire over half a million annual health-related tourists annually.
Individuals have realized that they have greater alternatives other than receiving regional health-related therapy and it is their correct to check elsewhere and take benefit of the truth that the improvement of the indicates of transportation along with the web is turning our planet into a “worldwide village”.
Two significant factors for travelling to another nation for healthcare remedy is availability of more sophisticated health-related technologies with ongoing research in the particular field of surgery and reduced healthcare expenses as many individuals do not have suitable medical insurance coverage (or any at all) and when in need to have of surgery, they can not afford to pay for it in their home nations.
India’s private healthcare sector offers the most advance healthcare remedies and technology offered in the world right now. There are 22 robotic systems in distinct centres across India and a talented pool of surgeons performing robotic surgery in a variety of specialities. Additional, in countries like USA and Australia, Robotic Surgery procedures price anyplace amongst $ 40, 000 – $ 75, 000 which is around four instances more than the cost prevailing in India.
The most advanced healthcare service is now offered right here at a fraction of cost compared to other nations. And following getting health-related treatment and recovering, sufferers are totally free to preserve travelling and take pleasure in a vacation in India and the nations surrounding it as India is located in the heart of East Asia.
I strongly believe that Robotic Surgery will offer a boost to the already current health-related tourism industry in India and will bring income and prestige to the country. We count on a lot of medical value trips / tourism facilitators to companion with programs like ours to additional grow awareness internationally and further boost our reach in health-related service and science.
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Case Studies:
Saroj Srivastava, 65, a former diplomat, on whom India’s initial ever robotic double vessel bypass process was performed, says, “I was petrified about undergoing a bypass, as it entails opening the chest and cutting the breastbone to access the heart. But then I was told that a robotic bypass requires generating just four fingertip-sized incisions in the body and that, it final results in significantly less blood loss, much less discomfort and a lot faster recovery.” Srivastava decided to go for it and was enjoying breakfast with her household the quite next day of the surgery. Discharged just 3 days later, she says smiling, “I was up and about inside a week’s time. I am glad I opted for it.

The positive aspects of robotic surgery are not just restricted to the heart. Robotic surgery can be applied in other specialities as well. Take for example, the case of Deepa Vaid,44, who had been suffering from excessive bleeding due to uterine fibroids and was advised to undergo a hysterectomy. Says Vaid, “I was so stressed out.” My husband was suffering from severe back discomfort, so I was taking care of my two youngsters, my 85 year old mother-in-law and a organization all on my personal. I had noticed my niece undergo laparoscopic hysterectomy. She had so a lot difficulty just altering side and was bed-ridden for over a month. I could not afford such a extended recovery time!” So, when her gynaecologist informed her that with robotic surgery, she won’t have to go via that ordeal, she was relieved. “It was nothing less than miraculous!”, she says. ” I was discharged in just two days and was back at work in a week! There was hardly any blood loss, minimal discomfort and negligible scarring – and no require to even change the dressing.”

Considerably, robotic surgery is also endorsed by individuals in rural India, like 72 year old farmer Dharampal Singh from Bela village, Haryana. Singh’s son Prahlad who’s a BSF constable recounts, “An open heart procedure would have meant a month or a lot more of bed rest. My father weighed about 115kgs and assisting him sit or get up from the bed would have been difficult.” So, right after consulting with BSF medical doctors, they decided to opt for a robotic bypass. “My father was property in just six days and on his feet soon soon after. That as well without having getting his chest split wide open!” Singh, who has turn into the village celebrity, had a really practical reason to go robot. “Is umar me maut se kisko darr lagta hai? Par kaun maheeno bistar pakadkar rehna chahta hai? (Who is afraid of death at this age? But who would want to be bed-ridden for months?), he says.

Be it a septuagenarian or tiny youngsters, this new procedure is providing hope to several in India. Take the case of one year old Aditya Khandelwal from Kota, Rajasthan, who was suffering from Vesico Ureteral Reflux (VUR) – a condition in which the valve between the ureters (the tubes that carry urine away from the kidneys) and the bladder does not function properly. Says father Dr. Anish Kandelwal, a basic practitioner, ” For eight months, he had recurrent infection, high fever and was losing weight. We brought him to Delhi and go for robotic ureteric re-implantation. If we had opted for the open process, it would have been extremely painful for my small boy – specially the 48 hours soon after the anaesthesia wears off. It would have taken him at least a couple of months to recover. Also, post operative care would have been quite hard, as restraining a one particular year old from playing and producing sudden jerky movements is challenging. Adds Aditya’s mother, “At no point did I feel that my son was undergoing a major surgery. He was playing in his room just two days following the operation.” So what made this attainable? Robotic Urologist Dr, Anant Kumar, who performed the operation on Aditya explained, “Effortless access to little infant structures produced the surgery precise and simpler, which would not have been possible with rigid laparoscopic instruments.

ICRS gives individuals the most sophisticated as nicely as economical remedies. Dr. Sudhir Srivastava is a Chairman, CEO and Managing Director, International Centre for Robotic Surgery, New Delhi, India