This document provides an overview of robotic surgery in India. It discusses the types of robotic surgery systems including supervisory-controlled, telesurgical, and shared-control systems. It outlines some common robotic procedures like abdominal, cardiac, gynecologic, head and neck, and urologic surgery. The benefits of robotic surgery for both patients and surgeons are highlighted. It also discusses robotic surgery costs in India which are significantly lower than in other countries. Top cities for robotic surgery in India are mentioned.

1. Dr. Dheeraj Bojwani
Your Medical Tour Consultant in India
Dr.DheerajBojwani Consultants
Website : www.dheerajbojwani.com

2. Robotic Surgery in India
Overview:
Surgical robotics is a new technology that holds significant promise. Robotic surgery is
often heralded as the new revolution, and it is one of the most talked about subjects in
surgery today. Up to this point in time, however, the drive to develop and obtain robotic
devices has been largely driven by the market. There is no doubt that they will become an
important tool in the surgical armamentarium, but the extent of their use is still evolving.
This surgery is a new and exciting emerging technology that is taking the surgical
profession by storm. Up to this point, however, the race to acquire and incorporate this
emerging technology has primarily been driven by the market. Moreover, robotic devices
seem to have more of a marketing role than a practical role. Whether or not robotic
devices will grow into a more practical role remains to be seen.
Why Robotic Surgery?
Robotic surgery is a type of procedure that is similar to laparoscopic surgery. It also can be performed through smaller surgical
cuts than traditional open surgery. The small, precise movements that are possible with this type of surgery give it some
advantages over standard endoscopic techniques. Sometimes robotic-assisted laparoscopy can allow a surgeon to perform a
less-invasive procedure that was once only possible with more invasive open surgery. Once it is placed in the abdomen, a
robotic arm is easier for the surgeon to use than the instruments in endoscopic surgery. The robot reduces the surgeon’s
movements (for example, moving 1/2 inch for every 1 inch the surgeon moves), which reduces some of the hand tremors and
movements that might otherwise make the surgery less precise. Also, robotic instruments can access hard-to-reach areas of
your body more easily through smaller incisions compared to traditional open and laparoscopic surgery.
What are the Types of Robotic Surgery?
Following are the types of robotic surgery systems:
Supervisory-Controlled systems: (a.k.a. Computer Assisted Surgery) are the most automated of the three. The surgeon
undertakes considerable prep work, inputs data into the robotic system, plans the course of action, takes x-rays, tests the
robot's motions, places the robot in the appropriate start position and oversees the robotic action to ensure everything goes as
planned. The most famous prototype is the RoboDoc system developed by Integrated Surgical Systems, which is commonly
used in orthopedic surgeries.
Telesurgical systems: The Telesurgical robotic system is the second type of device used in modern robotic surgery. The most
common variety, the Da Vinci Robotic Surgical System, enhances the surgery by providing 3-D visualization deep within hard-
to-reach places like the heart, as well as enhancing wrist dexterity and control of tiny instruments. This technology allows
surgeons to make quicker, more controlled and more accurate movements by using the robot arm with its wider range of
motions. It also allows more surgeons to perform these procedures, since many of the techniques performed by robot
assistants are highly skilled and extremely difficult for humans to master. Now more procedures (like artery repair and valve
repair) can be done without long recovery times or bodily injury.
Shared-Control systems: The Shared-Control System is the final category of robotic surgery devices. In this system, the
human does the bulk of the work, but the robot assists when needed. In many cases, the robotic system monitors the surgeon,
providing stability and support during the procedure. Before getting started, the surgeons program the robots to recognize
safe, close, boundary and forbidden territories within the human body. Safe regions are the main focus of the surgery. Through
forced feedback in the surgical tools, the system will limit their use within the appropriate area. As with supervisor-controlled
systems, there is some setup required by the surgeon prior to the procedure to define the regions of the surgical field.

3. Robotic Radiosurgery Systems: Robots are also used in delivering radiation
for the treatment of tumors. These systems use robotics to control highly
focused beams of ionizing radiation to precise locations within the body.
Medical imaging first locates the tumor and a map of the area to be treated is
created. A series of commands are then entered by the physician into the
system to instruct it how to deliver the treatment. The patient is then registered
with the system for proper positioning of the body and the treatment is begun.
The robotics will then follow the commands to precisely deliver a series of
doses to the tumor. This reduces the risk of damage to surrounding tissues.
Applications of Robotic Surgeries
Robotic surgery is particularly useful in certain situations or surgeries. For example, in laparoscopic surgeries, or surgeries in
which a laparoscope is used, the arms of the robot are extremely helpful. The most common procedures are:
Gastro-jejunostomy, Thoracic
Pyloroplasty
RY gastric bypass for obesity,
Esophageal surgery
Esophageal Myotomy for achalasia,
Thymectomy
Nephrectomy for transplantation and bile duct surgery
Mediastinal Tumor Resection
Lobectomy
Biventricular Resynchronization Epicardial Leads
General
Adrenalectomy
Cholecystectomy
Cardiac
Esophagectomy
Gastric Bypass
Heller Myotomy Atrial Septal Defect Repair
Nissen Fundoplication Mitral Valve Repair
Coronary artery bypass
Others
Cutting away cancer tissue from sensitive parts of the body such as blood vessels, nerves, or important body organs
Gallbladder removal
Hip replacement
Hysterectomy
Kidney removal
Kidney transplant
Mitral valve repair
Pyeloplasty (surgery to correct ureteropelvic junction obstruction)
Pyloroplasty
Radical prostatectomy
Tubal ligation

4. Common Robotic Procedures
Robotic Abdominal Surgery: Surgeons use robot-assisted techniques for abdominal procedures ranging from gallbladder and
appendix surgery to hernia repair and treatment for rectal cancer. Most patients, who undergo robotic procedures experience
significantly less postoperative pain, leave the hospital sooner and return to normal activities more quickly. For people with
rectal cancer, robotic surgery can also help prevent damage to vital nerves and tissues. In the past, it was difficult to treat
cancers in the lower part of the rectum without removing the anal sphincter, the muscle that controls elimination. This meant
that some patients needed an artificial opening in the abdomen to eliminate waste (colostomy). But that changed with the
advent of robotic surgery. Because robotic arms are more flexible than standard laparoscopic tools and allow greater precision
in difficult areas, experienced surgeons now can often spare delicate nerves to preserve sphincter control and sexual and
urinary function.
Robotic Cardiothoracic surgery: This approach enables your surgeon to reach your heart through small incisions in the side of
your chest wall rather than by splitting open the breastbone. Avoiding a long chest incision reduces pain and recovery time so
you resume normal activities sooner. Robotic surgery also leaves smaller, less noticeable scars than open chest surgery, has a
lower risk of infection and may lessen blood loss. Robot-assisted surgery can treat heart problems that are present at birth as
well as those that develop later in life. The robot technology is used to repair heart valves and congenital heart problems,
including atrial Septal defects and atrioventricular canal defects. It is performed without splitting the breastbone or stopping
your heart, robotic off-pump bypass usually means fewer complications, less postoperative bleeding, a shorter hospital stay —
often just 48 hours — and quicker recovery. Robotic off-pump bypass also offers more durable results, sparing you repeat
operations, and extends the option of bypass surgery to people who might not otherwise be candidates for the procedure.
Robotic Gynecologic surgery: this is done using the da Vinci robotic system for gynecologic surgery and assisted in the
process. The use of the system has led to safer, more effective, less intrusive treatments for a wide range of pelvic disorders
affecting women. These include:
Cervical cancer
Endometriosis
Hysterectomy
Pelvic organ prolapse, especially vaginal prolapse and paravaginal defects
Uterine cancer; vaginal fistulas
Uterine fibroids
Vaginal fistulas
Because robotic technology helps surgeons operate and suture with greater accuracy and flexibility, many women experience
markedly less postoperative pain, reduced scarring and a faster return to normal activities. Depending on your age and the
procedure, robotic surgery may also help preserve your fertility and improve reproductive health.
Robotic Head and Neck surgery: Is a new robotic procedure performed through the mouth (transorally) to treat cancers of the
tongue base and tonsils. Transoral robotic surgery offers many advantages over conventional head and neck procedures. The
maneuverability and precision of the robotic arms help surgeons operate more easily in the small spaces of the mouth and
throat. Robotic surgery also offers far better visualization of tumors. The ability to operate in multiple directions and to see in
three dimensions helps surgeons effectively eliminate cancer while sparing healthy tissue, reducing complications and
improving quality of life. Most patients who undergo Transoral robotic surgery also undergo a simultaneous open operation to
remove lymph nodes in the neck. Even so, the majority of patients leave the hospital in about three days and are able to
swallow within two weeks — much sooner than is common with other treatment methods. Studies of Transoral robotic surgery
show that most people have excellent outcomes.

5. Robotic Urologic surgery: is the procedure in which your surgeon removes the prostate gland and surrounding lymph nodes
through five or six small abdominal incisions. One of the most notable advantages of this approach is fewer traumas to delicate
tissues and reduced blood loss. Less than 1 percent of men who undergo robotic prostatectomy require a transfusion, as
opposed to 5 to 15 percent of those who have open prostate surgery. The result is a faster, less complicated recovery. The
enhanced precision of robotic surgery also makes sparing vital nerves easier and reduces the likelihood of complications such as
sexual or urinary dysfunction. The patients who are candidates for traditional open or laparoscopic surgery are also candidates
for robotic prostatectomy. Robotic surgery offers outcomes similar to those of standard laparoscopic surgery, with less tissue
trauma and blood loss, reduced risk of infection, and significantly faster postoperative recovery. You can expect one to three days
of hospital recovery following robotic surgery, as opposed to traditional open surgery, which usually requires a stay of up to five
days.
Benefits of Robotic Surgery
Robots in the field of surgery have dramatically changed the procedures for the better. The most significant advantage to Robotic
Surgery to the patient is the decrease in pain and scaring. The Robotic System is changing surgical procedures, which may
improve both the patient's experience and surgical outcomes. It reduces trauma to the patient by allowing surgery to be
performed through small ports or "keyholes" rather than large incisions, resulting in shorter recovery times, fewer complications
and a reduced hospital stay. By integrating computer-enhanced technology with the surgeon’s expertise, the da Vinci System
enables surgeons to perform extremely delicate and precise minimally invasive surgery (MIS).
The patient may experience the following benefits
Reduced trauma to the body
Less anesthesia
Often less blood loss and need for transfusions
Less post-operative pain and discomfort
Less risk of infection
Shorter hospital stay
Faster recovery and return to normal daily activities
Less scarring and improved cosmesis
The surgeons have the following benefits
Enhanced 3-D Visualization
Improved Dexterity
Greater Surgical Precision
Improved Access
Increased Range of Movement
Reproducibility
Simplifies many existing MIS surgical techniques
Makes difficult MIS operations routine
Makes new MIS procedures possible in most surgical specialties
Complications of Robotic Surgery
Possible reasons that can lead to unsafe operation of a medical unit include flawed design, malfunction of hardware and software
components, misinterpretation and incorrect or inadequate specification. As in many other applications, improving some of these
parameters results in a degraded performance in other areas, while an overall increased level of safety is accompanied by an
increase in cost, complexity, or both

6. Before Robotic Surgery
You cannot have any food or fluid for 8 hours before the surgery. If you are having certain types of abdominal surgery, your
surgeon may recommend that you cleanse your bowels with an enema or laxative the day before surgery.
Stop taking aspirin, blood thinners such as warfarin (Coumadin) or Plavix, anti-inflammatory medications, vitamins, or other
supplements 10 days before the procedure.
After the Procedure
You will be taken to a recovery room after the procedure. Depending on the type of surgery performed, you may have to stay in
the hospital overnight or for a couple of days. You should be able to walk within a day after the procedure, depending on what
type of procedure was done. Avoid heavy lifting or straining until your doctor gives you the okay. Your doctor may advise you not
to drive for at least a week.
Recovery
Because the surgical cuts are typically smaller than with traditional open surgery, robotic surgery may lead to:
Faster recovery
Less pain and bleeding
Less risk of infection
Shorter hospital stay
Smaller scars
Robotic surgery in India
Indian healthcare is growing day by day and it has marked new level of success. The Indian doctors have the credit of performing
the country's first robotic surgery for prostate cancer. India is gaining popularity internationally due to the robotic surgery in India
at very low cost along with world class medical amenities with best results. These factors have driven thousands of international
patients from all across the globe for various medical treatments including the Robotic surgery in India.
Having the industry's most elaborate and exclusive Patient Care and Clinical Coordination teams stationed at the Indian
hospitals, they provide the patients the smoothest and seamless care ever imagined. With a ratio of one Patient Care Manager to
five patients our patient care standards are unmatched across the sub continent. The various medical treatments and surgeries
performed in India are available at hospitals in the following cities with latest amenities and state-of-art-facilities.
Mumbai Hyderabad Kerala
Delhi Pune Goa
Bangalore Nagpur Jaipur
Chennai Gurgaon Chandigarh
The additional warmth and care the global patients receive while going for various medical treatments and surgeries surpasses
all the value added services they avail at their respective places.

7. Robotic Surgery Cost in India
Advanced methods of treatment are available in India at pocket friendly prices. India offers outstanding medical services at 60-
80% less than prevailing USA rates. Even with travel expenses taken into account, the comprehensive medical tourism packages
still provide a savings measured in the thousands of dollars for major procedures. The following cost comparison is a good
curtain raiser for patients looking for medical services in India.
Procedure Cost (US$)
Medical Treatment United States India
Robotic Cystectomy 7,50,000 95,000
Hysterectomy 20,000 3,000
Catarct Surgery 2,000 1,000
Orthopedic Surgery 20,000 6,000
Heart surgery 30,000 8,000
Some of the common countries from which patients travel to India for surgery are:
USA UK Canada
Australia New Zealand Nigeria
Kenya Ethiopia Uganda
Tanzania Zambia Congo
Sri Lanka Bangladesh Pakistan
Afghanistan Nepal Uzbekhistan
ABOUT INDIA
Located in South Asia, bordered by Pakistan, Nepal, China and Bangladesh, India is South Asia's largest, sovereign, democratic
republic. India has an edge over other countries when it comes to offering comprehensive, cost-effective and timely medical care:
it also offers an exotic, adventure-filled or cultural -if you wish array of destinations to discover and revel in for the travelers.
Indian cities like Mumbai, Hyderabad, Goa, Bangalore, Nagpur, Kerala, Delhi, Pune, Jaipur, Chennai, Gurgaon, and Chandigarh
offers best medical tourism service.
Mumbai - Formerly known as Bombay, is the commercial & financial capital city of India. Mumbai is famous for many things,
including its thriving Bollywood film industry, teeming bazaars, colonial-style buildings, Art Deco structures and a superb choice of
restaurants, often being rated as the dining capital of India. The tourist district of Colaba in Mumbai is a great place to start
exploring this great city.
Hyderabad – Hyderabad city is a great place to visit in the state of Andhra Pradesh. The place has witnessed a continuous
growth for last many years. Hyderabad has become a tourist hotspot following ever increasing number of tourists during past few
years. Hyderabad has a well-founded reputation as one of the safest cities in the world.

8. Goa - The country's smallest state and famed for its colonial Portuguese and Catholic past, most tourists visit Goa for its
endless selection of sandy beaches and coastal attractions. Standing proudly next to the Arabian Sea, Goa is a particularly
compact state and often feels like a large town, being easy to travel. Around Goa, tourists will soon realize that the state has
much more to offer than simply stunning beaches, fishing, water scooters, windsurfing and scuba diving.
Bangalore - Beauty lies in the eyes of beholder and if you want to see one of the most beautiful places in India then Bangalore
is the word for it. Bangalore has earned sobriquets like 'Silicon Valley of India', 'Pub Capital of India', and 'City of Gardens'.
Pleasant climate with colorful gardens with lakes and glittering nightlife, Bangalore has made its own attraction for travelers as
one of the most charming cities in India,
Nagpur - Nagpur is the largest city in central India, but with its friendly atmosphere and dependable transportation, you’ll
instantly feel at home. The city of Nagpur has a well-built infrastructure, is a clean and affluent city which makes a good
jumping-off point for a series of trips into the far eastern corner of Maharashtra.
Kerala - Natural beauty, clean air and primordial greenery amidst the vast expanse of water and sky, typifies the state of Kerala
– better known as God's own country. Kerala is famous for its alternative medical therapies such as Ayurveda, which help to
rejuvenate and revitalize the body. The region is also home to India’s only virgin tropical rain forest – the Silent Valley National
Park, supporting an overwhelming range of life forms, many of which are highly endangered, and endemic to this part of the
planet.
Delhi - "Welcome to The Capital City of India - New Delhi" Delhi is famous as Capital city of India is located in North India. Delhi
is truly a symbol of the old and the new; a blend of ancient well preserved monuments and temples along with jam-packed
burger joints and up market shopping malls. Delhi has state of the art Hospitals and the best qualified doctors.
Pune - Once referred to as the Oxford of the east, Pune continues to be a stronghold for academics and culture. An array of
factors like availability of efficient and experienced doctors, comparatively low treatment costs, hospital facilities of international
standards and many more have made Pune one of the top destinations for medical tourism.
Jaipur - Jaipur is one of the most popular destinations on a tourist's itinerary. The magnificent forts, beautiful havelis and
colourful bazaars make Jaipur a popular tourist destination among tourists. Jaipur has pioneered health and medical tourism in
India.
Chennai - Chennai is one of the most developed urban centers in the Indian subcontinent. The city forms the capital of Tamil
Nadu state and is the fourth largest metropolitan city in India. They have some of the very best hospitals and treatment centers
in the world. Each hospital is equipped with state of the art facilities. The technology brought into practice is the very latest,
including robotic surgery.
Gurgaon – It is one of the four important satellite cities of the National Capital Region and is often referred to as the 'Millennium
City.' Gurgaon has recently emerged as the latest hub for Medical Tourism. Apart from being IT hub and a favorite haunt for
MNC offices, the city has a number of world class hospitals that not only treat Indian citizens but also people from outside.
Chandigarh - Chandigarh is a rare epitome of modernization co-existing with nature's preservation. It is here that the trees and
plants are as much a part of the construction plans as the buildings and the roads. India’s first planned city, Chandigarh is a
rich, prosperous, spic and span, green city rightly called “THE CITY BEAUTIFUL”.

9. Patients Testimonial:
Mr. Sidney – Nigeria
Robotic Surgery in India
Hi, I am Sidney from Nigeria. Recently I had my Robotic Prostate Surgery in India which was very well expedited by the
medical consultant Dheeraj Bojwani Group. A millions Thanks to them for making my medical journey smooth and hassle free.
I came across the website of Dheeraj Bojwani group while browsing for Robotic Prostate Surgery in India. I found this
information satisfactory; moreover, the packages for Robotic Prostate Surgery in India provided by Dheeraj Bojwani group
seemed quiet promising. I then discussed my case with them and was proposed with some good offers of having my Robotic
Prostate Surgery in India. Soon I was in India. The arrangements were perfect; everything seemed properly carved and
planned.
Soon I got my Robotic Prostate Surgery in India. I really liked the ambience and cleanliness at the hospital. The hospital staff
was very courteous and friendly. What impressed me was their hospitality, they are truly professionals. The surgeon who
performed my Robotic Prostate Surgery in India was a true gentleman and had immense of experience in his field. I really
enjoyed my stay for my Robotic Prostate Surgery in India. I am sure now I can recommend it to my friends and relatives. At
the end I must thank the executives of Dheeraj Bojwani Group, also to the best surgeon-I ever came across and the medical
staff that helped me to walk free through the Robotic Prostate Surgery in India. I really want to thank everyone. God bless them
all!
Thank you,
Mr. Sidney
Nigeria

10. Knee Replacement Surgery in India
Knee replacement surgery also known as knee arthroplasty is procedure to replace the
weight-bearing surfaces of the knee joint to relieve the pain and disability of
osteoarthritis. It may be performed for other knee diseases such as rheumatoid arthritis
and psoriatic arthritis. The procedure has been proven to help individuals return back to
moderately challenging activities such as golf, bicycling, and swimming. Total knees
are not designed for jogging, or sports like tennis and skiing (although there certainly
are people with total knee replacements that participate in such sports). Knee
replacement is a routine surgery performed on over 600,000 people worldwide each
year. Over 90% of people who have had Total Knee Replacement experience an
improvement in knee pain and function.
Knee Replacement Surgery Candidates
A person would be considered a candidate for knee replacement if there is:
• Daily pain
• The pain is severe enough to restrict work, recreation and ordinary activities of daily living
• Significant stiffness in the knee
• Significant instability (constant giving way) of the knee
• Significant deformity (knock-knees or bow-legs) that hinders normal function of the knee
• Damage from arthritic conditions, such as osteoarthritis, rheumatoid arthritis or post-traumatic arthritis
Success Rate of Knee Replacement Surgery:
Knee replacement surgery is recognized as a miracle of modern surgery. Most orthopedic experts consider replacement to be
the best method of handling arthritis in the knee. Knee replacements have literally put hundreds of thousands of Americans
back on their feet and allowed them to enjoy their golden years.
Knee Replacement Surgery Preparations:
• If you smoke, cut down or quit. Smoking changes blood flow patterns, delays healing and slows recovery.
• If you drink, don't have any alcohol for at least 48 hours before surgery.
• Ask your doctor for pre-surgical exercises. If you are having hip or knee replacement surgery, doing exercises to
strengthen your upper body will help you cope with crutches or a walker after surgery.
• Your primary care physician or an internist will conduct a general medical evaluation several weeks before surgery.
This examination will assess your health and your risk for anesthesia. The results of this examination should be
forwarded to your orthopaedic surgeon, along with a surgical clearance.
• Shortly before your scheduled surgery, you will probably have an orthopedic examination to review the procedure and
answer any last-minute questions.
• You may need to take several types of tests, including blood tests, a cardiogram, a urine sample and a chest X-ray.
• Advice your surgeon of any medical conditions you have and of all the medications you are taking. You may need to
stop taking certain medications or your surgeon may recommend substitute medications until your surgery.
Medications such as corticosteroids, insulin or anti-coagulants will need to be managed before and after surgery.