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Robotic Surgery - About the Department

At Jaslok Hospital, we have a dedicated Robotic Surgery department which dramatically enhances the visualisation, precision, control and dexterity of the surgical procedure by helping the surgeons in performing complex surgery in a manner never before experienced. With advanced surgical enhancements, our surgeons are now capable of extend the benefits of minimally invasive surgery to the broadest possible range of patients.

With Urology, Nephrology and Oncology being at the top end of the spectrum of technology intensive specialities worldwide, Jaslok Hospital has always been up to the challenge with the induction of the latest 4th generation robotic surgery system, the DaVinci Xi Robotic platform.

What is robotic surgery?

In a robot-assisted surgery, the surgeon uses the assistance of a robot to perform the surgery using the Minimally Invasive Surgery technique. Robot-assisted surgery is a step forward in providing cutting edge treatment and is set to become the standard procedure over the next few years. The robot adds to the capability of the surgeon to perform a surgery. However, the robot does not do anything on its own and it is still the surgeon who does the surgery. The da Vinci Si Surgical Robotic System with simulator is the latest robotic system to be used to perform surgeries. With the commissioning of the robot, Asian Robotic Surgery Institute is the pioneering institute in the country to bring the latest generation robot to this part of the world and is aiming to become one of the pioneers and leaders in robotic surgery.

How does robotic surgery differ from a normal surgery?

Most critical organs of the body which require surgery (to correct any defect or disease) are located deep inside the body. To reach it, a surgeon has to make a large incision (cut) in the skin (which is around 10-12 inches), and muscles or breast bone (in case of a heart surgery) to access the organs and perform the surgery. Though this traditional way of doing surgeries is extremely safe and time tested, the patient suffers from pain, requires more blood transfusion, takes longer to recover (4 to 6 weeks) and often has a scar. In a Minimally Invasive Surgery (MIS) or laparoscopic surgery (key hole surgery), the surgery is done by entering the body minimally. Instead of a large cut, the operation is done through 1 to 2 cms small cuts (key holes), through which the surgeon passes instruments to perform the surgery. This has resulted in many surgeries moving from open to key hole surgeries. Robot-assisted surgery is an advancement of the MIS. Since surgery is done through small incisions of 1 to 2 cms only, the blood loss, trauma and the pain suffered by the patient is minimized to a large extent. Moreover, the recovery of the patient is much faster -the 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. Also the cosmetic outcome is superior, with minimal scars on the body. 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 naturally occurring hand tremors are filtered out by the computer's software thus increasing the precision.

What are the key benefits of Robot-assisted surgery?

• It is an advancement over MIS/Iaparoscopy • Surgery is done through small incisions of 1 to 2 cms only

• Insignificant blood loss and hence no/less requirement for blood transfusion

• Less trauma and pain • Less chances of infection and tissue damage

• Faster recovery - discharge within 1 to 3 days as opposed to 7 to 10 days in conventional surgery

• Patient goes back to normal life in 5 to 7 days

• Superior cosmetic outcome with minimal scars

• Overall precision of surgery is greater

• Robot gives the surgeon better control over surgical instruments, absorbing hand tremors (if any). Moreover, the range of movements of the robotic arms is better than the human wrist, thereby increasing precision

• Better view of the surgery site - the 3D magnification screens allow very clear, magnified view of the operative area which is 20 to 40 times better than the naked eye, thus helping the surgeon to do operations more accurately.

Specialties where Robotic Surgery can improve outcomes : -

UROLOGY and URO ONCOSURGERY

This is the speciality where robotic surgery has become the surgery of choice for various conditions

Conditions where it has now been proven to be of benefit are:

• Radical prostatectomy for cancer of prostate
• Partial and total nephrectomy - surgical removal of kidney
• Pyeloplasty - reconstruction of renal pelvis to drain kidney
• Cystectomy - removal or urninary bladder to remove abnormal cyst
• Adrenalectomy - removal of adrenal gland to remove tumor
• Vesicovaginal fistula surgery - surgery to close or remove fistule between your bladder and vagina

Main specific advantages

• Excellent vision in the pelvis
• Less chances of nerve damage
• Easier Suturing under vision

2.GYNAECOLOGY AND GYNAEC ONCOSURGERY

This is a rapidly growing speciality for robotic assisted surgery

Gynaecological surgeries which can have improved outcome

• Wertheim's hysterectomy for cancer of uterus
• Myomectomy for fibroids removal from uterus
• Oophrectomies and lymph node dissection - removal of ovaries
• Endometriosis

Advantages

• Easier as all organs are in the pelvis
• Better vision
• Suturing is easier
• Less pain and faster recovery

3.GENERAL AND GI SURGERY AND GI ONCOSURGERY

Surgeries which can benefit the patient:

• Robotic pancreatic and liver resections
• Robotic spleenectomies - surgical removal of spleen
• Robotic assisted cholecystectomies - surgical removal of gall bladder

4.COLORECTAL, COLORECTAL ONCOSURGERY AND PELVIC FLOOR SURGERY

Because of difficult access to the pelvis (lowermost part of your body) with traditional surgery robotic assisted surgery is gaining ground for these surgeries as technically the vision is better and surgery more accurate

Surgeries where patients can benefit:

• Anterior resection for low rectal cancers
• Sphincter saving surgery for ultra low cancers
• Ventral mesh rectopexy for obstructed defaecation and prolapsed
• Sacrospinous fixations for vault prolapse with pelvic floor repair

Specific Advantages:

• Better vision
• Less chance of nerve damage resulting in better continence and sexual recovery
• Less blood loss
• Safe and accurate suturing

Area of expertise

female urology

Awards/Fellowship

Past president urological society of India(west zone),past president mumbai urology society Awards - Dr. G M Phadke award, Vijaywada prize, CKP Menon award,best paper in masicon 1997,1998,1999,best paper award in Int surgeon conference 1999 Foreign awards - Invited faculty in EUA Barcelona 2010 faculty in Masterclass in Female urology from 2010 till 2015 Invited to conduct instructional course in Melbourne Australia 2015 Invited as a faculty for 50 th year Egyptian urology association at Cairo 2015 Conducted more than 45 operating workshop all over India and neighboring countries

Academic achievements-chief of female urology section of Urological society of India from 2007 to 2013.,invited to American Urology association in sandiago for instructional course in female urology in 2013

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Area of expertise

Head and Neck, Gastrointestinal, Gynaec and Breast Malilgnanceis

Brief write up

Honorary Consultant in surgical Oncosurgery. Attached to Jaslok Hospital since 1997. After finishing his MS general Surgery from KEM he underwent Oncosurgery training from the TATA memorial hospital for 8 years. Has many publications to his name in various national and international journals.

Awards/Fellowship

"1. Visiting Fellowship in First Dept.of surgery for Esophageal cancer at Kurume University school of Medicine.

2. Visiting Fellowship in Dept. of Surgery for Esophageal and gastro-intestinal surgery at Queen Mary Hospital, University of Hong kong.

Awards

1) “S R Joglekar Gold Medal” for Best scientific article for 1993 Ind. J Surgery

2) “C V Menon Gold Medal” for Best scientific article(co-author) for 1994 Ind J Surgery

3) Prof. K.P. Sinha/ Prof. P.S. Krishnan Award for Best paper published in Ind. J Clin Biochem 1996"

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Area Of Expertise :
- Fibroid treatment
- Advanced laproscopic surgeries
- Laproscopic pelvic floor repair
- Laproscopic Hysterectomies for Gynaecological Malignancies
- Corrective surgeries for Utrine malformtions
- Robotic laparoscopy
- Laparoscopic oncology
- Endoscopic surgeries

Education :
Dr. Neeta Warty received her Endoscopy training at Friedrich Schiller University, Germany with Prof. Marc Possover and Dr. Rakesh Sinha in Mumbai.

Brief Write up:

After completing her Masters from Mumbai University, she received her formal training in Laparoscopy from Friedrich Schiller University, Jena, Germany and worked with stalwarts in the field of Laparoscopic Onco-Gynecology like Prof. Schneider and Prof. Marc Possover. She has also trained in Laparoscopic Oncology at Whipps Cross Hospital, UK. She has received training in Robotic Laparoscopy from Dr. Puntambekar, Pune and also from Dr Choi Gyu Seoug, Korea. She has developed the Laparoscopic Shirodkar Sling Surgery for Uterine Prolapse which is recognized in Shaw's Textbook of Gynecology and Unification of bicornuate uterus which was felicitated at Basel University, Switzerland.

As recognition of her pioneering work, she has been nominated as the India Representative of the International Society of Pelvic Surgery, Cologne, Germany.

Considered to be an expert in both laparoscopic and endoscopic surgery, her successful achievements in gynecology surgery like hysterectomy surgery, endometriosis surgery and fibroids surgery have set a benchmark.

Besides surgery, she has the experience and the expertise for the diagnosis and management of routine and complex gynecological conditions like endometriosis and PCOS.

Dr. Neeta Warty specializes in the areas of Advanced Laparoscopic Surgeries like Laparoscopic Pelvic ?oor repair for Prolapse of uterus, Tubal Reconstructive Surgeries, Laparoscopic Hysterectomies for Gynecological Malignancies including Lymph Node sampling, treatment for Stress Urinary Incontinence, and corrective surgeries for uterine malformations.

Dr. Neeta Warty was part of the team that successfully conducted the country's first uterus transplant in May 2017.

Awards/ Fellowship:

She has developed the Laparoscopic Sling Surgery for Uterine Prolapse and her work is recognized in Shaw's Textbook of Gynecology. This also won a place in the innovative surgeries at Montreal ISGE. Recently she has developed a technique for robotic unification of Didelphys uterus.

She is a FOGSI Corion Awardee for her pioneering work in Laparoscopic Reconstruction of Bicornuate Uterus. She has the unique distinction of having demonstrated this work at the University of Basel, Switzerland.

She also specializes in removal of Large Fibroids for which she finds mention in Limca Book of Records and Guinness Book of World Records.

As recognition of her pioneering work, she has been nominated as the India Representative of the International Society of Pelvic Surgery, Cologne, Germany.

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Area of expertise

Basic and Advanced Laparoscopic Surgery, Liver and Pancreatic Resections, Acute and Chronic pancreatitis, Reoperative surgery, especially Repair of Bile duct injury at cholecystectomy, Surgery for Portal hypertension, Surgery in chronic liver disease, Gastrointestinal cancers

Brief write up

I have been working as a specialist Surgical Gastroenterologist since 1997 at Jaslok Hospital and Research Center. Our Department of Surgical Gastroenterology is nationally and internationally recognised as a Center for tertiary care in this specialty and as a training centre for the 3year postgraduate degree course in Surgical Gastroenterology awarded by the National Board in Delhi. Apart from providing a service for relatively simple problems like Gallstone disease, we are referred patients from all over India and neighboring countries for treating complex GI problems like Recurrent abdominal sepsis, Liver and Pancreas surgeries, Reoperative abdominal surgery, and Gastrointestinal Cancers.

We have an academic multidisciplinary approach to the treatment of these problems with well trained Anesthetists, Intensive care physicians, Endoscopy services and Interventional Radiology services to ensure outcomes at par with the leading international centers.

Awards/Fellowship

"Gold Medal in General Surgery from the University of Mumbai

TopDoc award 3 years in a row voted by peers as Best doctor in the specialty in Mumbai

Fellowship in Hepatobiliary Surgery at Mayo Clinic "

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Area of expertise

Endourology (PCNL, URS, Flex URS), Laser surgery for the Prostate and for stones, Laparascopy and Robotics for Urological Cancer and for Reconstructive Urology, Renal Transplantation

Brief write up

Dr. Chibber took his basic medical and general surgical training and degree from the TN Medical College and Nair Hospital , Mumbai.

He stood FIRST in the University of Mumbai at the MS (Gen Surgery) exam and also at the FCPS examination. He took his specialized training in Urology at the University of Edinburgh Department of Urology and Renal Transplantation at the Western General Hospital, Edinburgh.

He took further training in percutaneous Renal Surgery and Radiology at the Institute of Urology : the St Peter’s and Paul’s Hospitals, London and at the Long Island Jewish Hospital, New York.

Dr. Chibber pioneered the practice and teaching of PCNL, Ureteroscopy and Laparosopic Urology in India.

He was Hon. Professor and Head of Urology and Renal Transplantation at the Grant Medical College and the JJ Group of Hospitals and left after 25 years.

He has also been with the Jaslok Hospital for the last 25 years."

Awards/Fellowship

• President of the Urological Society of India (2015)

• Past President of the West Zone Chapter of the USI and of the Mumbai Urology Society.

• Examiner at PG exams in Urology at the Mumbai University, Gujarat University, All India Institute of Urology etc.

• Four Gold Medals for standing first in the University of Bombay (MS)

• Gold Medal for standing first at the FCPS examination

• Invited scholar at the Cleveland Clinic for Laparoscopic Urology

• Director of Laparoscopic Training at the Johnsons & Johnson Course in Mumbai

• Training Faculty at CEMAST, Mumbai

• Numerous citations, orations and invited lectures in India and abroad (USA, Europe, UK, and Australia) "

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Area of expertise

laparoscopic surgery for bowel cancer, crohns and colitis

Brief write up

"Dr Prajesh bhuta completed his basic surgical training in one of the premier hospitals in Mumbai

He subsequently went to the UK to subspecialise in colorectal surgery.

Over 10 years in the UK he has gained immense experience in dealing with all bowel related issues both benign and malignant.

He was previously a consultant colorectal surgeon at st Helens and knowsley hospital Liverpool where he was the clinical lead of day care and laparoscopic unit.

We offer minimal invasive approach for piles ,fissures and fistulas

He is a part of pelvic floor unit at jaslok looking into pelvic floor issues like constipation, prolapsed and incontinence.

His combined experience from Indian and Europe helps him to offer a multidisciplinary and evidence approach at jaslok for all surgical diseases for the latest and best chance of cure. "

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Area of expertise -

Cervical Cancer, Endometrial Cancer, Gynae-oncology, Ovarian Cancer, Hipec & Ip Chemotherapy, Robotic Surgery for Benign and Malignant Gynaecological Conditions, Vulvar Cancer

Brief write up -

Dr Nyati has over 10 years of dedicated experience in the management of Gynaecological cancers (women cancer). After getting his basic post-graduation (DNB OBGY) qualification at the B. J. Medical College & Sassoon General Hospital, Pune, he did his specialty training in Gynaecologic Oncology at Tata Memorial Cancer Center, Mumbai. Due to his dedication towards women cancer & spreading awareness for prevention & early diagnosus,International gynecological Cancer Society (IGCS)awarded upon him the prestigious Travelling scholars program for advance fellowship & training in Gynecological oncology, at Mayo clinic (Rochester, USA), University of California(UCI) Irvine USA, University of South California (USC) & Keck school of medicine, Los Angeles USA.With his vast experience he has mastered the expertise in tailoring the advance innovative technology & treatment with precision as per the need of individual patient with empathetic care. He also has been part of clinical trials & conferences for the improvement in management and quality of life for our women patients. He also has presented papers & received accolades in his field. With his aim to provide a better outcome for women, he has conducted cancer awareness camps and programs from time to time for awareness about prevention & early detection of women cancer. With sincere efforts, technical advantage and strong determination, Dr. Nyati has added an edge to the comprehensive treatment & care to Gynecological Cancer patients.

Awards/Fellowship -

1st prize at AMOGs 2001 Pune- Poster presentation
1st prize at PRAYAS 2002 Pune Panel discussion
2nd prize at POGS 2003 Pune Paper presentation and 2nd prize at Annual Conference of Association of Gynaecologic Oncologists of India (AGOICON) 2007 Madurai Paper presentation

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Area of expertise

Basic & advanced laparoscopic surgeries, Open/laparoscopic: Hepatobilliary and GI Surgery, Liver, Pancreas and Gall Bladder Surgeries, Colorectal Surgeries"

Brief write up

He is qualified Gastroenterologist at Jaslok Hospital since last 4 years. He has done fellowship in Hepatobilliary & liver transplantation. Presented many papers at national as well as international level and published articles in peer reviewed journals

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Area of expertise:

Dr. Rakesh Katna is associated as a Consultant Head & Neck Onco Surgeon at Jaslok Hospital. He did his Clinical Fellowship at Tata Memorial Hospital with 4 years of experience in Head & Neck Surgery. He has also been trained in all procedures related to Head & Neck

Oncosurgery along with Reconstructive Plastic Surgery. He has done fellowship in "Endoscopic Thyroid Surgery" from National Centre Of Endocrinology at Hanoi, Vietnam and Robotic Surgery (TORS) from Seoul, Korea. He has been interest in Endolaryngeal Surgical procedures, Skull Base and Minimal Access procedures for Thyroid

Brief write up:
Head & Neck Surgery
Reconstructive Plastic Surgery
Endolaryngeal Surgical Procedures
Skull Base and Minimal Access procedures for Thyroid

Awards/Fellowship:
1. Sekhsariya Fellow Tata Memorial Hospital,
2. HBNI Clinical fellow Tata Memorial Hospital,
3. Surgical Fellowship in Endoscopic Thyroid Surgery at National Centre of Endocrinology.
4. TORS (Transoral Robotic Surgery) Assam Medical Centre, Seoul – Koreo

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Area of expertise

Upper tract endourology, Neuropathic Bladder, Stress urinary incontinence in women, Renal transplantation (including cadaveric renal transplantation), Male erectile dysfunction

Brief write up

Dr. Shailesh Raina is Director of Urology and Renal Transplantation and Diat the Jaslok Hospital, South Mumbai. He is one among the top urology doctors in Mumbai. Worked Urological Surgery at The Royal Infirmary at Bristol, UK, Worked the Somerset Hospitals in Taunton, UK. Worked at Institute of Urology, London, Trained in robotic urology at AALST, Belgium & Strasburg, France

Dr. Raina is the first person in India to have used the HPS 120 Watts Laser for Prostate

Helped set up Stone clinic at JHRC in 1989, introducing lithotripsy, upper tract endourology (PCNL & URS), & has expertise in minimally invasive techniques for stone diseases for over 25 years.

Awards/Fellowship

* First in the country to use HPS 120 & 180 green light laser for BPH * Keen interest in Endo urology, Female Urology, Neuro urology, Renal Transplantation

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Area of expertise

Gynaec services offered:
Puberty health issues
Contraceptive management
Endometriosis
Fibroids
Management of abnormal uterine bleeding
Menopause
Scarless Hysterectomy
Minimally Invasive Surgeries (Key Hole surgeries)
Robotic surgeries ( precise and advanced form of key hole surgery)
Urogynaecology such as Prolapse, urinary incontinence & sexual dysfunction
Repair of Pelvic floor laxation
Pelvic Pain
Ovarian cysts
PCOS
Obstetric services offered
Pre conceptional counselling
Management of Normal pregnancies & pregnancies complicated with Diabetes, High blood pressure, heart disease, thyroid, Kidney & other problems, infections, etc.
Management of premature pregnancies/labour
Management of pregnancies with small and sick babies
Management of multiple pregnancies such as Twins & triplets
Management of pregnancies with abnormalities in unborn foetuses
Management of repeated miscarriages
Management of ectopic pregnancies

Brief write up

"Dr. Sudeshna Ray holds a respectable reputation amongst her patients both as an Obstetrician & Gynaecologist.

Apart from imparting her expert advice, she believes in empowering women with the knowledge to decide and accept her treatment. To her every woman coming to her is important and she gives sufficient time to each one of them to decide the treatment which is best suited for her. Besides guiding the pregnant women with her expert advice, she offers a full range of gynaecological services. This includes preventive care for a healthy women & treatment of various gynaecological concerns such as fibroids, endometriosis, abnormal bleeding, PCOS, etc. She enjoys bringing healthy babies to the world and to her the smile in the eyes of the parents and the gratitude of a treated women is what keeps her going through the odd hours of continuous work.

She is also passionate about giving her women the best & the most advanced form of treatment available in the form of non-surgical options, scarless, robotic, keyhole procedures and multidisciplinary management when required."

She is the head of the team of LIGHTHOUSE – the 360 degree care program for adolescents and young adults.

Awards/Fellowship

"FELLOWSHIP

Pelvic Endoscopy from BEAMS, Mumbai.

Diploma in Obst & Gyn Ultrasound (FDGSI).

Invited faculty for training, lectures and presentations in various conferences, workshops and academic meetings

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