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Role of Robotic Surgery in Gynecologic Oncology in India
              but that is expected to decrease with the increased experience   concLusIon
              of the surgeon.
            •  Length of stay in the hospital: it was seen in most studies to be   India is notably at the brink of a revolution. The need of the hour
              lesser than the laparoscopic surgeries.          is to make this new surgically innovative technology accessible to
            •  Other costs: Other expenditure ssuch as consultations with other   all—to the surgeons as well as the patients. Robotic surgical training
              departments, ICU care, blood transfusions, and so on needs to   is essential for surgeons to help keep up with this revolution so that
              be accounted for individually.                   the man and machine are in sync and move ahead together. It is
                                                               up to the undoubted talented surgeons of India to embrace this
               As seen above it is clear that the major cost is due to the robot   technology to render better quality of medical care to the society.
            itself, the disposable working instruments and its maintenance.
            Now, on broader inspection we can safely assume that once other
            Robotic systems come into the market the scenario will change  references
            drastically. Though one may argue that the other costs may also     1.  Dogra PN. Current Status of Robotic Surgery in India. JIMSA 2012;
            contribute significantly, it is seen that robotic surgery is associated   25(3):145–146.
            with lesser blood loss, lesser complications, and lesser need for     2.  Mahesh D, Jaspreet C, et al.  Robotic surgery is ready for prime
            intensive care.                                         time in India: for the motion. J Minim Access Surg January–March
               Once newer robot systems become available and easily   2015;11(1):2–4. DOI: 10.4103/0972-9941.147649.
            affordable, there may be an overuse of the same even in cases     3.  Lesley BC, Pedro TR, et al. Role of minimally invasive surgery in
                                                                    gynecologic oncology: an updated survey of members of the
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            surgery should not be neglected. It becomes the responsibility of     4.  Patricia M, Gilles H, et al. Cost-Effectiveness of Conventional
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                                                                    Indications. Int J Gynecol Cancer 2015;25(6):1102–1108. DOI: 10.1097/
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            future of robotIc surgery In IndIA                   5.  Shailesh PP, Nallapothula K, et al. Indian Experience of Robotics
            Though our country is on the right track with regard to utilization   in Gynecology. J Minim Access Surg 2014;10(2):80–83. DOI:
            of this technology, much research is needed to make it more   10.4103/0972-9941.129957.
            productive and cost-effective. This has to be based on critical     6.  Weinberg L, Rao S, et al. Robotic surgery in gynecology: an updated
            analysis of evidence-based literature available regarding the same   systematic review. Obstet Gynecol Int 2011;2011(5):852061. DOI:
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            improve with more experience.                         7.  Boggess JF, Gehrig PA, et al. A case-control study of robot-assisted
               Mass media has a role of paramount importance in creating   type III radical hysterectomy with pelvic lymph node dissection
            awareness among the surgeons and patients alike regarding the   compared with open radical hysterectomy. Am J Obstet Gynecol
                                                                    2008;199(357):e1–e7. DOI: 10.1016/j.ajog.2008.06.058.
            advantages and accessibility of this technology as there is no dearth     8.  Lowe MP, Chamberlain DH, et al. A multiinstitutional experience with
                   11
            of critics.  The government also has to come up with suitable   robotic-assisted radical hysterectomy for early stage cervical cancer.
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            lack of awareness about the same in many parts of the country due     9.  Shailesh P, Geetanjali  A, et al. Robotic Oncological Survey: Our Initial
            to lack of access to the technology, deficit of learning opportunities   Experience of 164 Cases. Indian J Surg Onco 2012;3(2):96–100. DOI:
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               Since the introduction of DRS this revolution has gained     10.  Hollaway RW, Patel SD, et al. Robotic Surgery in Gynecology. Scan J
                                                                    Surg 2009;98:96–109.
            momentum and it may just be a matter of years when open and     11.  Yim GW, Kim SW, et al. Learning curve analysis of robot-assisted
            laparoscopic surgeries will be considered outmoded. With the   radical hysterectomy for cervical cancer: initial experience at a
            introduction of telesurgery, the prospects are innumerable and   single institution. J Gynecol Oncol 2013;24(4):303–312. DOI: 10.3802/
            not at all beyond imagination.                          jgo.2013.24.4.303.


























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