In Chennai, doctors successfully perform India’s first Robotic Cytoreductive Surgery

Dr. Ajit Pai and a team of surgical oncologists in Chennai have successfully performed India's first Robotic Cytoreductive Surgery for peritoneal surface cancer.

Apollo Cancer Centre’s surgical oncologists in Chennai have successfully performed India’s first Robotic Cytoreductive Surgery (CRS) with Hyperthermic Intraperitoneal Chemotherapy (HIPEC) for a peritoneal surface cancer

In this procedure, cancerous tumours are removed from the abdominal cavity surgically and the cavity is then washed with hot chemotherapy— at 42 degrees Celsius— to kill any microscopic cells that may remain. This raising of temperature is referred to as hyperthermia, when chemotherapy drugs are heated and delivered directly into the abdomen and effectively kill cancer cells. This overall improves the overall cytotoxicity effect on cancer cells and hence, the treatment outcomes.

first Robotic Cytoreductive Surgery
Source: Medicaljagat

Administering chemotherapy drugs directly into peritoneal cavity via intraperitoneal installation also allows for significantly higher doses of chemotherapy drugs compared to whole-body administration. By targeting chemotherapy at the site of the cancer, higher drug concentrations can be achieved in the tumour area while minimising exposure to healthy tissues and organs elsewhere in the body. This localised delivery helps maximise the effectiveness of the treatment while reducing the risk of systemic toxicity. 

Breakthrough: First Robotic Cytoreductive Surgery Performed

According to ANI, A 51-year-old woman was diagnosed with bilateral overian masses and had to go through a long history of surgical intervention. This included removal of the uterus, ovaries, appenndix and part of the omentum. A histopathological examination revealed a high grade mucinous tumour of the appendix, pseudomyxoma peritonei (PMP)— that paved the way for another additional first Robotic Cytoreductive Surgery. 

first Robotic Cytoreductive Surgery
Source: ANI

Despite the initial first Robotic Cytoreductive Surgery, residual mucinous implants were found in the patient’s pelvis and around the cecum. Appendix cancer has a specific tendency of spreading to the abdomen’s lining (peritoneum). Dr. Ajit Pai and his team, then, opted for minimally invasive Robotic Cytoreductive Surgery. This involved several procedures aimed at reducing the amount of cancer cells in the abdominal cavity, such as right hemicolectomy and complete mesocolic excision. Alongside this, they performed peritonectomy and omentectomy, along with administering HIPEC to eliminate any potential microscopic residual tumours within the abdomen. 

Traditionally, CRS/HIPEC procedures have been performed as open and extensive operations— requiring heavy incisions and prolonged hospitalisation. The Robotic CRS approach, however, offers significant advantage by being minimally invasive. The clinicians used tiny 8mm incisions for robotic instruments, and a single sternocleidomastoid (SCM) incision was used for tumour removal and delivery of HIPEC. 

first Robotic Cytoreductive Surgery
Source: Youtube

Robots are more precise, leaving less chances of damage to normal and healthy cells. More precise and less invasive also means that less damages will be done, that enables faster recovery, less complications and a better quality of life.

The patient remains in perfect health, one year after the first Robotic Cytoreductive Surgery, and is now cancer free. 

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