NAGPUR: Though a very investment intensive proposition, robotic surgery is emerging as a positive option in treating infertility in women through surgical intervention. A Pune-based doctor, Dr Shailesh Puntambekar has performed 380 such surgeries in last three years in cases of endometriosis (painful periods), hysterectomy (removal of uterus) and opening and joining of tubes (tubectomy).

Sharing his experience with TOI Dr Puntambekar, director of Galaxy Care Laparoscopic Institute, admits that though the surgery is still out of the reach of even the middle class, its precision and accuracy are giving good results. “I do it mainly for oncological or cancer treatment but robotic surgery has proved very effective for fertility enhancing operations in women. It has an edge over both open procedures as well as minimal invasive procedures like laparoscopy,” he said.

Dr Puntambekar was in city for a talk in the CME and workshop on intrauterine insemination (IUI) and medical disorders in pregnancy organized by the Nagpur Test Tube Baby Centre (NTTBC) and the Nagpur Obstetrics and Gynaecology Society (NOGS).

Robotic surgery has proved to be extremely effective in complex and difficult situations. “Ligating the minute fallopian tubes in a woman is done so finely by the robot that human hand can never match. The suturing in all surgeries is also very fine and precise. This is possible also due to the great magnification robotic instruments offer,” said Dr Puntambekar.

Women who have severe pain during the periods due to endometriosis, a gynaecological condition in which the cells in the lining of the uterus also start developing outside the uterus causing hormonal imbalance. Such women are so desperate they do not mind the cost if they are completely cured. Also, in women with blocked tubes or those who underwent tubectomy as a family planning measure but end up with need of a child for some reason the tubes can be accurately joined back again.

The surgery, however, requires an initial investment of about Rs 9-10 crore for basic set up. For every surgery, a Rs 40,000 robotic arm is discarded as a disposable. “Since I am doing surgeries in a big way, it is now turning out to be an economical venture. Initially it is not something every surgeon can set up,” said Dr Puntambekar. For patients, the cost can range up to anything from Rs 1 to Rs 1.5 lakh.

The robotic advantage

* It is more accurate and precise as it is done with very high resolution (40% higher than human eye) compared to the 20% higher resolution in laparoscopic surgery

* The surgery is done in a 3-D manner. Human hand cannot rotate beyond 170 degrees during a surgery while the surgical arms of the robot can rotate entire 360 degrees

* Is not cumbersome as the surgeon merely controls the robots looking through the console (eyes of the equipment) while they do the job

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