Kalpana Nagpal
With clear advantages, such as higher patient comfort, safety and shorter length of stay at hospital, Robotic surgery is becoming a preferred mode of surgery. This paper describes our clinical experience of 200 cases at department of ENT and Head and Neck surgery, Indraprastha Apollo Hospitals (IAH), New Delhi, India. From November 2016 to February 2021, we have performed 200 Robotic surgeries, with various approved indications in ENT and Head and Neck using da Vinci Si (Intuitive Surgical systems, Sunnyvale, CA, USA). We used a 30 degree angled binocular scope (12mm) with monopolar cautery in one arm and Maryland dissector (5m) in the other, with specialized retractors for gaining access. Satisfactory results were found in almost all robotic assisted surgeries. Majority of surgeries were performed for sleep apnea [TORS- Transoral Robotic Surgery] for base of tongue reduction with or without epiglottoplasty resulting in improved Apnea-Hypopnea Index (AHI) levels. We noticed significant subjective improvement with minimal complications and excellent functional outcomes. Second most frequent procedure performed was thyroidectomy via trans-axillary and retroauricular (facelift) approach and results were encouraging. Other surgeries performed were T1 and T2 laryngeal malignancies, parathyroid surgery, T1 and T2 stage tonsil and base of tongue cancer, haemangioma base of tongue, parapharyngeal mass, lingual thyroid, submandibular gland dissection, palatal tumor, chronic lingual tonsillitis and Eagle’s syndrome. In our experience results of robotic surgeries are very satisfactory for both patients and surgeon. Robotic surgery has definite benefits over endoscopic and open approaches with multiple advantages and few drawbacks commonest being high consumer cost, which is a significant amount in a developing country like India. In numerous domains of surgery, recent developments in equipment and surgical techniques have made minimally invasive surgery (MIS) a well-tolerated and efficient technique. It has various advantages over traditional surgical techniques, including faster recovery, lower postoperative infection rates, less pain, improved postoperative immune function, and superior cosmetic results [1–3]. As a result, robotic-assisted surgery (RAS) has grown in popularity in a variety of surgical specialties, and many institutions are now investing in medical robotic technology for use in general, urological, cardiac, gynaecological, and neurological surgery.
