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Robotic Surgery explained fully

What exactly is Robotic Surgery?
  • A surgeon employs a state-of-the-art robot to enhance surgical capabilities. The surgeon is in control and the robot merely carries out the surgeon's 'instructions'. A SURGICAL ROBOT DOES NOT DO ANYTHING ON ITS OWN.
  • Robotic Surgery employs the Minimally-Invasive technique. It is an enhancement of the Minimially-Invasive technique and It has so many benefits; it is set to become the standard surgical procedure all over the world in the next few years.
  • Asian Hospitals was the first in Mumbai, the first in Western India, and one of the first in the Asia Pacific region to offer truly state-of-the-art Robotic Surgery.
Robotic Surgery
How does Robotic Surgery differ from normal surgery?
  • Most of the critical organs of the human body are located deep inside the body. This means every surgeon needs to make a large incision (cut) in the skin and muscles (or in the case of cardiac surgery, in the breast bone) to access the organs and operate. This is, of course, the traditional surgical manner. It is safe and time-tested. But the patient cannot avoid suffering pain, from requiring blood transfusions, and must prepare for a long period of recovery (sometimes 4 to 6 weeks). Many times, the patient has a scar for the rest of his/ her life.
  • In Minimally Invasive Surgery (MIS), or laparoscopic surgery (commonly known as key-hole surgery), the surgery is accomplished by 'minimally' entering the body. A large cut is unnecessary. The entire operation is carried out through 1 to 2 cms cuts ('keyholes') through which the surgeon passes the instruments to do the entire surgery. As you can see, this has made it possible to change 'open' surgeries to 'keyhole' or 'minimally-invasive' surgeries.
  • Robot-assisted surgery is an advancement over Minimally Invasive Surgery (MIS). Since surgery is done through small incisions of 1 to 2 cms only, the blood loss, trauma, and pain suffered by the patient is minimized to a large extent. Moreover, the recovery of the patient is much faster.A patient gets discharged within 2 to 3 days as opposed to the 7 to 10 days needed through the traditional technique. The patient can resume a normal life and go back to work within 5 to 7 days. The cosmetic outcome is superior, with minimal scars. The overall precision of the surgery is greater since the robot gives the surgeon better control over the surgical instruments and a better view of the surgical site (the operative field is magnified by about 40 times), compared to other minimally invasive approaches. The robot is so advanced; it filters out any naturally-occurring hand tremors, thus increasing the precision.
How does the robot assist a surgery?
  • The robotic system enables surgeons to perform delicate and complex operations on the heart, kidney, prostrate, gall bladder, ovary, uterus, thyroid, etc. For example, thyroid surgery can be done through the axillary route (through the under arms with no scar on the neck).
  • The surgeries are done through a few tiny incisions, with the simultaneous advantage of increased vision, precision, dexterity, and control. The key componentsof the robotic system include:

Surgeon Console: This is where the surgeon sits while operating. It is located in the same operating room which means that the surgeon is physically present all throughout the surgery. Instead of directly moving the instruments, the surgeon uses the console to move the instruments which are attached to the robotic arms. The computer translates the surgeon's movements, which are then carried out precisely by the robot. Through out the surgery, the surgeon is able to get a high resolution view of the inside of the patient's body.

Patient Side Cart: This is where the patient is made to lie down for the surgery. It includes 4 robotic arms that carry out the surgeon's commands. The robotic arms move depending on the movement specified by the surgeon at the console, which means that the operation is under direct control of the surgeon. The robotic arms are fitted with surgical instruments which enter into the body through keyhole incisions of 1 to 2 cms. The robotic system translates the surgeons hand movements into micro-movements of the instruments to perform the surgery. Repeated safety checks prevent any independent movements of the instrument or the robotic arm.

Endo Wrist Instruments: These instruments are attached to the robotic arm and are designed to give a range of movements even greater than the human wrist. An integrated tremor filter detects and filters out any tremors in the surgeon's hand movements, so that they are not duplicated robotically. This further enables the surgeon to perform various surgical operations with a greater level of precision.

Vision System: The vision system is equipped with a high-definition, 3D endoscope (flexible tube with a camera and light at the tip) that provides live images of the area to be operated. The surgeon gets a magnified view of the robotic movements which is 20 to 40 times more magnified than naked eye, thus helping the surgeon to do more accurate operations.

How expensive is Robotic Surgery? What is the minimum cost?

The cost of surgery will be marginally more than a laparoscopic surgery, but this cost is offset by the reduced cost of a shorter hospital stay, and an early return to work. There is also the 'savings' of minimal or no blood transfusion, the advantage of less pain with superior results as well as better cosmetic results.

How safe is a patient in the hands of a robot?

A patient is NEVER 'in the hands of' a robot. This is a common misconception. The patient is ALWAYS and ONLY 'in the hands of' the surgeon. The surgery is robot-assisted. The robot is NOT a surgeon; it is an advanced, high-tech machine that carries out the surgeon's instructions. The robot doesn't and cannot do anything by its own. It is the surgeon who does the entire surgery; the robotic arms mimicking the movements of the surgeon's hands and fingers. The onus and control of the entire surgery still lies on the surgical team. It is still the judgment, expertise and experience of the surgeon which makes the surgery successful. So you are as safe 'in the hands of' the robot as you would be in the hands of the surgeon, because you are always in the hands of the surgeon.

How much time does a Robotic Surgery take?

It depends on the specialty/category of the surgery. But as a rule, robotic surgery takes as much time as conventional surgery.

What happens if the robot malfunctions during surgery?

This would be an extremely rare occurrence. The machine is built to very strict quality standards, and is constantly maintained to a very demanding set of mandated inspections. It is also inspected before every surgery to very strict and mandated criteria of checks.

Nevertheless, the surgeon and the operation theatre team is always prepared to (and able to) convert the surgery to a laparoscopic surgery or an open surgery.

How many clinical people are present during a Robotic Surgery?

As many as there are during conventional surgery: all senior doctors, the entire surgical team, and all the attendant technicians.

Does the robot administer anaesthesia?

Absolutely not. It is ALWAYS the anaesthesiologist who administers anaesthesia.

How can I opt for Robotic Surgery?

Patients cannot opt for robotic surgery by themselves. If a patient requests robotic surgery, a specialist in the particular field will need to review the patient and his reports to ensure that the patient is suitable for robotic surgery. The patient is encouraged to consult his own doctor too. Robotic surgery is an option that a patient can elect ONLY IF all the concerned doctors agree that it is a better option. Robotic surgery is offered to a patient as an alternative to conventional surgery only when a patient has met all necessary criteria.

Are there any special precautions that I need to take before undergoing Robotic Surgery?

None whatsoever. There are no special precautions to be taken for a robot-assisted surgery. The precautions and pre-op procedures remain the same as they are for a routine surgery. The pre-op tests done prior to the procedure are similar to the tests done prior to a routine surgery.

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Asian Heart Institute

G / N Block, Bandra Kurla Complex, Bandra (E),
Mumbai 400 051, Maharashtra, INDIA.


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