In November 2018, the Presidential Hospital officially launched the Kazakhstan International Reference and Training Center for Robotic Surgery, which is openedat theMedical Center Hospital of the President’s Affairs Administration of the Republic of Kazakhstan. The project was presented to President NursultanNazarbayev.
For the first time in the post-Soviet space, a project has been created that combines all the possibilities of developing a new direction in the world medical practice - surgery with the help of a robot: this is practical medicine, training and advanced training of specialists, clinical trials and scientific developments. In fact, the center for robotic surgery brings Kazakhstan's medical science to a completely new, progressive level.
The unique clinical division of the Presidential Hospital will allow to comprehensively develop a new direction in medicine not only in Kazakhstan, but also in other countries.
The center solves one of the most important problems of modern medicine: it makes possible to train personnel for robotic surgery on the spot, without leaving the country. Full-cycle master classes at the Presidential Hospitalwill be held both for Kazakhstani surgeons and for colleagues from the Russian Federation and Central Asian countries.
The robotic operating room is a modern, most effective method of surgical treatment in urology, gynecology and general surgery. While retaining the advantages of laparoscopic surgery (when internal organs are operated through small holes on the patient's body), robot-assisted surgery has many additional advantages.
These are three-dimensional observation of the operating field and multiple magnification of the image of the operated organs; complete elimination of trembling of the surgeon’s hands; no need for large incisions and a quick recovery period of the patient; minimal risks of infection or large blood loss; reduction of the patient’s stay in the hospital; no serious pain after surgery.
Surgical instruments mounted on the robot’s mechanical arms allow the specialist to perform the widest range of movements with high accuracy. One of the manipulators is equipped with a three-dimensional camera that transmits a high-resolution image of the operated area of the area. It is important that the surgeon controls the robot’s actions, controlling each manipulation
Robotic surgery also improves the quality of cancer operations. Patients has no need for additional studies and stages of chemotherapy.
A well - known urologist, Dr. David Samadi, was one of the first in the world to use the new robotic technology. The reputable American surgeon has performed more than seven thousand operations and is currently consulting Hospital doctors, helping to master the new Senhance system of Transenterix. The doctors of the Hospital who perform operations using robotic surgery also successfully completed an internship in Italy, at the office of the manufacturing company. The project was created with the support of the First President’s Foundation.
Equipment: The robotic surgical system Senhanceis designed for performing robot-assisted minimally invasive surgical operations. Robotic consoles and a remote console control the endoscopic instruments.
The operating surgeon uses manipulators on a remote control console to control the movements of instruments mounted on robotic consoles. The system helps the doctor to perform surgical manipulations with high accuracy of movements up to 1 mm, in the most comfortable position, sitting in a special chair, while being outside the sterile area of the operating room.
The 3D visualization mode is provided by a video camera and a stereoscopic endoscope. The movement of the surgeon’s eyes through the integrated “Eye Tracker” system controls the movement of the endoscope in the operating space. The system allows performing operations in the following surgical areas: urology, gynecology, proctology, general (abdominal) surgery.
Advantages of robotic surgery:
The advantages that the robotic system offers to the operating surgeon, allows for an accurate and delicate operation. The surgical instruments of the robotic system eliminate the tremor of the hands (natural trembling), which is observed even in the most balanced specialists, which allows an experienced surgeon to perform surgical operations on a robot with jewelry and preserve microscopic neuromuscular fibers.
Surgical instruments mounted on the robot’s mechanical arms allow the specialist to perform the widest range of movements with high accuracy. One of the manipulators is equipped with a three-dimensional camera that transmits a high-resolution image of the operated area. It is important to note that the surgeon controls the robot’s actions, controlling each manipulation. The robot does nothing on its own, but obeys the “orders” of the surgeon sitting at the console in the operating room and activating the robot’s hands with the help of joysticks.
Due to the multiple increases in the size of the operating field and the high resolution of the optical system, the surgeon is able to separate tissues with high accuracy and unsurpassed accuracy. Special miniature instruments that control the fingertips allow the surgeon to perform manipulations that are inaccessible to the human hand.
A computerized system of adjustments and scaling of movements brings the manipulations of hands and tools into line, preventing errors related to the human factor. An effective security system controls the process of changing tools during the operation. All this creates ideal conditions for the surgeon to perform a surgical procedure with minimal blood loss and without complications.
The freedom of movement of surgical instruments with a size of several millimeters due to the zoom function and an enlarged three-dimensional image, gives the best operational result with minimal chances of complications. The minimally invasive technique of performing operations on a robot allows the patient to return to daily activity in the shortest possible time
The sitting position of the surgeon during the operation has a particularly positive effect on the result during complex operations, for example, during prostatectomy with bladder reconstruction.
Video clip from YouTube