Singapore Expertise Pioneers Quick and Scarless Surgery

  Patients with gastric tumors in their stomach will no longer have to suffer an 8-hour long surgery but instead can look forward to a short-day surgery, which lasts a few minutes to an hour without the need for hospitalization. This new procedure— the world's first flexible endoscopy robotic surgery in the stomach—was successfully performed on patients suffering from gastric tumors in India. The procedure was performed on a total of three patients, one patient per day from July 1 to 3, 2011. A flexible endoscope, which had small robotic arms, was inserted through the patient's mouth to the stomach, while the surgeon monitored it on a computer screen. Using joystick and buttons to control the robotic arms, the surgeon then removed the cancerous tumor and the patient went home after the operation.
This groundbreaking technology was developed by Associate Professor Louis Phee, Head of the Division of Mechatronics and Design, School of Mechanical and Aerospace at Nanyang Technological University (NTU), and Professor Ho Khek Yu Lawrence, Senior Consultant at the Department of Gastroenterology and Hepatology, National University Hospital, after 6 years of research. This system, named MASTER (Master and Slave Transluminal Endoscopic Robot) is entirely designed and built from scratch in NTU.
Current robotic keyhole surgeries still require a small cut at the stomach area to enable a rigid robotic endoscope to enter and do the surgery. This new flexible robotic endoscope does not require any external incision and enters through the mouth instead. By controlling an external console, the surgeon is able to make the robot perform intricate surgical procedures. For the surgeries done in India, the robot is used to perform endoscopic submucosal dissection (ESD): the delicate removal of a tumor embedded in the stomach wall without puncturing the latter. Without this robotic system, a patient is likely to undergo open surgery to remove the tumor. As ESD is considered a very difficult procedure, the robot is easily modified to perform many other procedures within the digestive tract.
This novel procedure also opens up new possibilities for surgery: the robot is able to cut a small hole in the stomach wall to get access to other organs like the liver, kidney, and pancreas to perform intricate surgery. After the surgery is done, it slides back into the stomach, mends the hole in the stomach wall, and exits out of the mouth again. It may come a time when a patient goes for surgery and all he or she needs do is open their mouth.
Apart from speeding up the operation process and leaving no scars, this robotic procedure is also significantly cheaper than normal surgery, thanks to its precision, dexterity, and maneuverability. The robotic arms, which is up to 6 mm in diameter, has the capacity to "feel" how hard or soft the delicate tissues of the stomach and intestines are, so doctors at the console can vary the pressure accordingly. The combined diameter of both arms is up to 16 mm.
In the future, it may be possible for such a surgical system to be controlled remotely from another part of the world. To carry out the experiments on the device's effectiveness and efficiency, a multicenter experiment was decided as collaborators from Hong Kong and Germany have shown keen interests. Since the Asian Institute of Gastroenterology (AIG) was the first to get the relevant approvals for human trials and patients were easily available there, they were the first center to carry out the operation. AIG is one of Asia's largest outpatient centers doing therapeutic endoscopy and has the credit of doing the most endoscopic retrograde cholangiopancreatography procedures in the word. In addition, Dr. Nageshwar Reddy, chairman and chief gastroenterologist at AIG, is one of the best gastroenterologists in the world and is known for his innovations. With the experimental operation carried out under his supervision, it would give the new surgAdidas Ultra Boost 3.0 Cny