BIG SURGERIES, SMALL INCISIONS

The scene inside one of the operation theatres of Escorts Heart Institute and Research Centre in Delhi, where a bypass surgery was being conducted last Wednesday, could not have been more different.

Sure, the doctors were alert, but they were also very relaxed. Most stood around, looking at the monitor, where the insides of the patient’s heart could be seen magnified several hundredfold. Others lounged about, talking, joking and even attending to the occasional phone call. Some even laughingly offered to take off their masks for the benefit of our photographer.

Part of the ease was probably because this was a ‘‘robotic surgery’’, perhaps the ultimate in high precision, minimally invasive procedures. Still, the man in the hot seat, in this case the ‘‘console’’, from where he conducted the operation, Dr Yugal Kumar Mishra, managed to keep a running commentary going for our benefit.

But isn’t a beating-heart bypass surgery a very complicated procedure that requires extreme concentration? ‘‘This is simple,’’ Mishra laughs, rubbing his hands in excitement. He could talk. After all, this was perhaps the 351st — or was it the 352nd — robotic surgery presided over by the man who took over as the director of cardiovascular surgery after Dr Naresh Trehan. The patient, he explains, will be up and about in around 10 days, compared to the 30-45 days in an ordinary surgery, where the chest has to be completely opened.

That is the beauty of the ‘‘minimally invasive’’ procedures, where instead of incisions of five inches and more, all the work is done by instruments inserted into the body through three or four half-inch cuts. Result: The trauma is reduced to a fraction, the recovery is faster and even the pain is much less.

‘‘Only three places in India have the facility of robotic surgery,’’ one of his teammates proudly says, ‘‘including the All India Institute of Medical Sciences’’. Part of the reason is that the medical community is divided over the necessity of the

Rs 12-crore instrument. Most agree that a robotic surgery is only essential for really complicated and time consuming processes, like removal of a cancerous prostrate gland, in which a 10-hour procedure can be reduced to two hours.

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