Alex, 66, looked peaceful as he lay on the operation table at a Hospital in India and Mako a surgical robot, went into action. He had a stage-4 arthritis in both knees and had been confined to his home for many months. He finally decided to undergo a knee replacement surgery hoping to relieve pain and reclaim his social life.

With its long, slender fingers and superb surgical skills. Mako stole the show at the operation theater. Be it creating a 3D model of Alex’s joint based on CT scan reports, creating boundaries, removing bits of patient knee or making precise bone cuts. Mako leaves one wondering about the blurring lines between robots and humans.

Once the surgery was done the jubilant team of Surgeons at Hospital collectively said, “Thank you Mako!” I looked up to see whether Mako smiled or bowed it head. Doctors and Chief of Orthopedic surgeon at the hospital told that Mako cannot smile back. Not yet! But it can put a smile on the patient’s face. “The pain is less and the recovery is faster. Even infection rate is less,” says Doctor.

Around 75% of the knee replacement patients opt for robotic surgery. Mako comes handy in hip replacement s as well. “How much of bone should be cut is decided by the robot, based on our capture of anatomy and CT scan reports. This help surgeons plan the surgery better and calculate the size of the implant accurately. Doctors have never had to change the implant size,” says Doctor.

Surgical robots have been the game changers. They are now being used in brain, spine, lung and heart surgeries. “Now we have robots not just for doing regular surgeries like knee and hip replacements, but also for abdominal surgeries that includes genecology, urology, colorectal and prostate surgeries” says Doctors at Hospitals in India. The robots are becoming more user friendly and more acceptable to patients.

Katy from Europe would vouch for surgical robots. The 46 year old had abnormal bleeding, was diagnosed with uterine cancer and underwent a robotic surgery at Cancer Hospital. “Her uterine cancer was thoroughly excised, with minimal impact on surrounding health tissues,” says Doctor a Gynecologic oncologist and robotic surgery expert at the center. Katy’s husband, Neil says his wife’s post operative pain was much less and recovery faster because of the robotic surgery.

Better than humans

Robots are better surgeons than human in many ways. Robotic wrists rotate 360 degrees. Using the joystick, the surgeon can curve the scissor upside down. It enhances the precision and causes less bleeding and damage to surrounding tissues. It also gives surgeons more control. The camera that goes in gives 3D view, allowing the surgeon to see the internal organs clearly. The camera also gives a magnified view of the area to be operated on.

At an operation theater in India. Jatin Prakash a 46 year old patient is about to be operated on. Prakash was diagnosed with a Kidney tumour following a health check up.

Doctors draws attention to a 3D monitor that shows a small blood vessel that’s going into the patient’s kidney. Consultant in Urology robotic surgery and renal transplantation takes special care to preserve the vessel. “Since there is no bleeding, people recover faster, and they experience less pain. Within a week or ten days, they are back to work. Traditional methods would require the patient to take rest for a month,” Doctor says.

Doctors and surgeons currently use fifth generation Da-Vinci robotic system. Da Vinci is a great tool for surgeons for operations on the heart, lungs, food pipe, chest and other organs deep inside the body.



1 A surgical robot that has four arms controlled by the surgeon.

2. A cart with an external monitor that is connected to a camera and the body of the patient. The surgeon can see images of the body part being operated on the monitor. there is a light source which takes the light inside.

3 A console where the surgeon sits. The surgeon controls the robot using two joysticks on the console. The surgeons movement are transmitted to the arms of the robot. the pedals on the console control the instruments that go into the patient’s body including the scissor and staplers which cut and seal the tissue.

Can robots use their discretion and perform surgeries on their own? Currently, robots are operated and controlled by surgeons. In the future, we may have robots that are more self-reliant and autonomous. Every time a robotic surgery is performed, the data is stored in the cloud. Once enough data is available, experts say artificial intelligence (AI) could be applied on it for robots to act autonomously.

Doctors finds it exciting that even a young surgeon can now produce results as good as those of senior surgeons with the help of surgical robots. Senior surgeons also have reasons to rejoice. “As you age, your diagnostic skills and ability to resolve a problem get better. A surgeon is at his or her peak arounf 55, as far as motor skills are concerned. Says a senior doctor. But then the journey downhill starts. “With robots, you can go no for much longer, because they take away the need for great motor skills.”



Robotic surgery tends to be more expensive than conventional surgery, but the outcomes are better and so the additional cost often seems justifiable for patients. ” A robotic surgery cost about 5000 USD in ENT specialty. if we compare cost to cost and hospital stay for conventional surgery, the difference may be in the range of 1000 to 1200 USD.


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Breast Cancer: The importance of screening

Is Breast Cancer preventable?

Sadly we don’t have any vaccine yet, and it’s not preventable. But with some measures, we can definitely catch the disease early, which is the key to a good outcome. However, it is important to know the risk factors. Apart from family history, your personal life choices like late or no pregnancy, not breastfeeding, smoking and drinking (alcohol) habits, obesity and sedentary lifestyle, early onset of periods and late menopause may play a role.

What can I do to protect myself?

If you have a family history of breast cancer, it is advisable to consult a specialist to understand the precautions you may need to take. It is advisable for all women beyond 30 to undergo regular screening. Breast self-explanatory is the first step. Look for any changes or abnormalities like lump, swelling, nipple discharge or puckering and talk to your Doctor.

How is breast screening done?

Screening means checking for lumps in your breast before they appear. breast screening involves getting a mammogram (X-ray of breast) for women above 40 years or an ultrasound breast for younger women.

What is the prognosis for breast cancer?

As compared to other cancers, breast cancer has a better prognosis if detected early. Early detection is the key. Chances of survival and cure greatly increase with timely diagnosis. Treatment would depend on the stage and type of cancer. Nowadays advanced treatment techniques ensure a better prognosis and much reduce chance of recurrence.


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Is Hernia A Cause For Worry?

What is a Hernia?

It is a condition where a defect or weakness in the abdominal wall causes an internal organ to push through the muscle or tissue that forms the wall. The resulting bulge can come and go and may or may not be painful. It can be a defect from birth or can develop over a period of time due to certain external factors.

What are its causes?

The causes can be a defect from birth, age, poor nutrition, constipation, straining during urination, constant coughing or sneezing, abdominal injury or surgery, improper lifting of heavy weight, being obese, peritoneal dialysis, etc.

Is it a serious condition?

Initially, it may not be serious, however, can become so if it gets stuck in the hole and cannot go back. This can be painful, lead to obstruction to the passage of intestine and in severe cases get cut off from the blood supply causing tissue death. Hernias tend to worsen over time.

What are the treatment options?

Over time, all hernias get bigger never smaller. It is always safe to repair hernias on an elective basis. The type of surgery chosen is determined by the severity and type of hernia one has and other ailments and requirements – these could be Hernia Repair with Robotic Surgery (with the fourth-generation Da Vinci Robot), Laparoscopic Hernia Repair or Open Hernia Repair Treatment.


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Acute respiratory distress syndrome: Treatment & Recovery

What is ARDS?

Acute Respiratory Distress Syndrome is a condition that occurs when inflammatory fluid builds up in the air sacs in the lungs, thus preventing the lungs from filling with enough air (oxygen). This causes severe respiratory distress and low oxygen saturation.

Who is at risk of ARDS?

ARDS is more likely to occur in patients who are critically ill like severe pneumonia, sepsis, pancreatitis, COVID 19, burns or critical injuries. The risk is greater in elderly people. Symptoms may include severe shortness of breath, labored breathing, low blood pressure, confusion and extreme exhaustion.

What is the prognosis of ARDS?

ARDS is a life-threatening condition. However, modern treatment methods include ventilation and advance heart-lung support systems like ECMO (Extracorporeal membrane oxygenation) in specialized critical care units today have greatly improved survival rates.

Can a person recover completely from ARDS?

This largely depends on the intensity of the disease and the duration of mechanical lung support that patient requires. Though some of them suffers from lung damage, treatment with ECMO has shown better long-term benefits when other modalities of treatment have failed. Pulmonary rehabilitation helps in faster recovery.


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Facts about Gynaecologic Cancer

What is Gynaecologic Cancer?

Cancer starts when cells grow out of control, and it can develop anywhere in the body. Gynaecologic cancers begin in a woman’s reproductive organs, in the pelvis, the area below the stomach. These are one of the leading causes of cancer-related deaths in women worldwide. The main five types of Gynaecologic cancer are Cervical Cancer, Uterine Cancer, Ovarian Cancer, Vaginal Cancer and Vulvar Cancer.

What are the symptoms of Gynaecologic cancer?

It is important to pay attention to your body and recognize the warning signs. Abnormal vaginal bleeding or discharge, intermenstrual/postcoital bleeding, feeling full too quickly or reduced appetite, bloating, abdominal, back or pelvic pain, urgent need to urinate and/or constipation, itching, burning, pain or tenderness of vulva and changes in vulva colour or skin such as rash, sores or warts.

How are Gynaecologic Cancers diagnosed?

Doctors begin be asking about your family & personal medical history and symptoms. A complete physical examination is done that includes a pelvic scan to check signs of problems in your reproductive organs. To confirm the diagnosis other tests may take place like biopsy, colposcopy, endoscopy, CT, MRI, PET/CT, USG.

Are Gynaecologic Cancers treatable?

Gynaecologic cancers are treated in several ways and have better survival prognosis than other cancers in the abdomen. It depends on the kind of cancer and how far it has spread. Treatments may include surgery (including robotic surgery), chemotherapy, radiation therapy and immunotherapy


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TAVR Latest Treatment For Heart Valves

With the rise in heart disease, there are many latest technology & research in cardiac treatment. Transcatheter  Aortic Valve Replacement (TAVR) is one such technology which is becoming increasingly popular in cardiac treatment

Why is TAVI / TAVR needed?

Human heart has got four valves. If one of these valves is narrowed, then it is called stenosis. Aortic stenosis is the narrowing of the left sided aortic valve due to ageing or birth defect which results in obstruction of blood flow from left ventricular chamber to vital organs of our body. Many patients suffer from this and ultimately die suddenly due to pump failure. Cardiac surgeons often do not want to treat elderly people, needing bypass surgery or opening of the chest for high risk of death during open heart surgery because of associated co-existing illness. In this high-group, nowadays, aortic valve can be treated by a stent in patient groin just like conventional balloon angioplasty, called a TAVI/TAVR (Trans aortic valve Implantation / replacement).

Advantage of TAVI / TAVR

There is no need for opening the chest or long stay in a hospital. Patients are usually discharge on the third day and they start their normal activity immediate after discharge. Though this stent is very costly device, but it is life saving in these in-operable high-risk patients.

Which patients should go for TAVR?

Currently the procedure is reserved for those people for whom an open-heart procedure poses intermediate /high risk. For that reason, most people who have this procedure are in their 70s or 80 and often have other medical conditions that makes them a better candidate for this type of surgery.

TAVR can be an effective option to improve quality of life in patients who otherwise have limited choices for repair of their aortic valve.

Case study

Mr BD was a 76 years old patient with past history of prolong smoking, was presented with shortness of breath on exertion and chest discomfort. His echocardiogram showed severe obstruction at aortic valve. Because of existing comorbidities Mr BD was falling in intermediate risk category for cardiac surgery and more so he had severe fright for any surgical procedure to him.

Considering all the aspects Hospital found him an appropriate candidate for the TAVR procedure which was done in 2019. Patient recovered and became ambulatory in next 48 hours. After the discharge he is doing well.

Facts About Prostate Cancer

What is Prostate Cancer?

The Prostate is a gland in males that produces the seminal fluid that nourishes and transports sperm. Prostate Cancer is one of the most common types of cancer in males. Many prostate cancers grow slowly and are confined to the prostate gland, where they may not cause serious harm.

What are the symptoms of Prostate cancer?

In the early stages, prostate cancer may not cause any symptoms but when it is at an advances stage, it may show signs like trouble urinating, decreased force in the stream of urine, blood in the urine, blood in the semen, bone pain, losing weight without trying & erectile dysfunction.

What are the common risk factors of Prostate Cancer?

Your risk of prostate cancer increases as you age. It’s most common after the age of 50. If you have a family history of prostate cancer or suffer from obesity, your risk of getting it may be higher.

Is prostate Cancer curable?

Yes, Prostate cancer can be cured if detected and treated at early stage. Treatment may include surgery, radiation therapy or hormones therapy. Robotic Surgery has revolutionized prostate cancer surgery.


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Know All About Inflammatory Bowel Disease (IBD)

What is IBD?

IBD is a condition where there is inflammation inside the digestive tract. The two types of IBD are Ulcerative Colitis(inflammation with sores or ulcers, along the lining of colon and rectum) and Crohn’s Disease (inflammation of the lining of your GI tract – from oesophagus to the anus).

What are the symptoms of IBD?

Symptoms can include severe fatigue, pain in the joints, loss of appetite, bleeding from the rectum, blood in stool, diarrhoea, abdominal cramps and loss of weight.

How is IBD diagnosed?

To diagnose the condition, your doctor would recommend certain blood tests, including complete blood count (CBC) & amp; stool test. Also, you may have to undergo one or more of these diagnostic procedures – Colonoscopy, EUS, Endoscopy, CT and MRI.

What are the treatment for IBD?

IBD treatments vary depending on the particular type & amp; symptoms. It is often treated with medications to control the inflammation. The doctor would recommend certain lifestyle changes. There is no cure for IBD, however the symptoms can be controlled by controlling the triggers. In rare cases, when medications do not help in controlling the symptoms, surgery may be required.


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Advance care for ‘birth-defect’ of heart


What is termed a congenital heart disease (CHD)?

It is a birth defect where a child is born with structural defects in the heart. The majority are simple defects like a small hole in the heart and can be closed by interventional device closure or surgery. Some may not need any active treatment. More complex issues like large holes and narrowing of valves may require major surgical intervention.

How will you know that your child has CHD?

The babies with congenital heart defects may show symptoms during early months of life. These include breathing and feeding difficulty, blue lips, tongue or fingernails and poor weight gain. Signs of the simple defects may show up much later in life, sometimes after attain adulthood. Major defects can be detected during pregnancy through foetal echocardiogram.

What causes CHD?

Though definite causes are not known, some factors like certain genetic abnormalities and environmental factors have been linked to the condition. The mother’s diet and health condition (like diabetes and obesity), medications that she takes and smoking/drinking habits may have links too.

How is the condition treated?

Treatment depends on the severity of the condition. Some children need surgery to repair the defect, while in others cardiac catheterization and transcatheter interventional(non-surgical procedure) are helpful. some heart defects cannot be fully repaired but treatment can help on improving blood flow to the heart. Some patients with complex congenital defects needs palliative treatment and would require to be monitored long term.


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Knock Knees – Treatable Paediatric Deformity

What are Knock Knees?

“Knock Knees” are a condition where the knees touch each other and ankles are wide apart. This results in an angular deformity of the entire lower limb. It can occur on one side or both sides. Most cases develop during late childhood and early adolescence. Very rarely it may be present at birth.

How does “knock knees” develop?

There is an unequal growth cartilage(physis) present in the lower part of the thigh bone and upper part of the leg bone. The physis can get damaged due to trauma (fracture), Infection (osteomyelitis), radiation or most commonly due to nutritional deficiency of Vitamin D (rickets).

What is the treatment?

Some cases can undergo spontaneous correction, usually in toddlers. In adolescents, correction usually requires surgery-growth modulation (guided growth) or corrective osteotomy (the bone is cut and realigned to its correct position).

Can physiotherapy or special shoes/braces help in correcting the deformity?

No. Physiotherapy can only help to improve muscle strength  and walking balance, while special shoes/braces may help to prevent the worsening of the deformity in certain cases.

What is the modern method of treating “knock knees”?

Guided growth or growth modulation is a relatively minimally invasive procedure, where a small plate and screws are inserted across the growth cartilage to guide its growth during the preadolescent or early adolescent age. After a few months/years, once the leg alignment gets corrected, the plates are removed.


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