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Robot operates on a two-day-old baby who was born missing an esophagus

A team of pediatric surgeons in India say they’ve successfully performed robotic surgery on a newborn.

The two-day old baby was born without a fully-formed esophagus and, therefore, was unable to eat, reported The Times of India.

Normally, the medical condition involves invasive surgery that requires surgeons to connect the two ends of the esophagus together.

But the medical team at the Post Graduate Institute of Medical Education & Research (PGIMER), one of India’s premier hospitals, decided to use a minimally invasive surgery, in which a robotic arm makes tiny incisions to fix the birth defect.

It comes as debate in the US and the UK rages on over whether or not this technology should be used regularly in hospitals.

Some doctors say robotic surgery involves less blood loss, less pain and more precise incisions for faster recovery. But others argue that the surgical systems are costly and that hundreds of cases have been documented of broken parts falling into patients’ bodies and electrical sparks that burned body tissue.

Doctors at the Post Graduate Institute of Medical Education & Research (pictured) in Chandigarh, India, say they’ve performed the first pediatric robotic surgery in Asia on a newborn

The baby was born on January 31 at Government Multi Specialty Hospital, Sector 16 in Chandigarh, India, according to The Times.

Doctors quickly noticed he had esophageal atresia, a rare, congenital birth defect in which the esophagus doesn’t form properly before birth.

The esophagus is a tube that runs from the throat to the stomach, carrying food and liquids. 

Doctors usually notice the condition after a baby’s tries to feed, but instead coughs, chokes and turns a bluish color.

According to a 2007 study from University College in the UK, esophageal atresia occurs in one in 3,000 live births.

The baby was born on January 31 at Government Multi Specialty Hospital, Sector 16 in Chandigarh, India, according to The Times.

Weighing just 5.5 pounds, which is a low birth weight, the newborn was transferred to PGIMER, less than two miles away.

According to a statement from PGIMER, the hospital sees about 250 cases every year of babies born with esophageal atresia. 

Conventionally, surgery involves opening the chest to connect the two ends of the esophagus to each other.

‘Opening the chest in a small baby is both stressful and traumatic,’ said Dr Ravi Kanojia, a pediatric surgeon at PGIMER who led the operation.

‘This is a very advanced surgery in which the esophageal reconstruction is done so early in life.’ 

But, for the first time, the surgical team used robotic surgery to treat the condition, which involved creating tiny incisions so the tools could enter the body, reported The Times.

Robotic surgery is minimally invasive and uses instruments attached to a robotic arm to enter a patient. 

Surgeons use a computer to control the robotic arm, which has been praised for being more precise, which lead to a faster recovery. 

‘Not only there was no requirement of blood transfusion, the days of hospitalization was cut short from a month to a week,’ said Dr Ram Samujh, the head of the pediatric surgery department at PGIMER.

The newborn was observed by the neonatology team for a week and, once they observed he was feeding properly, he was discharged.

The baby’s father is a security guard and the family lives below the poverty line, according to the hospital’s statement. 

‘For such patients, such world-class facility of robotic surgery costs Rs 10,000 ($140), which is two times that of a conventional surgery,’ said Dr Kanojia.

‘But as it reduces days of admission and chances of infection, the amount comes to almost the same.’

While a $140 surgery may not seem like it costs much to most Americans, Indians living below the poverty line earn the equivalent of $1.90 per day or less.

According to The Tribune, PGIMER provided free medical treatment for the baby. 

PGIMER has been performing robotic surgery on adults since 2014 and, in August 2017, it became the first government hospital to conduct pediatric robotic surgery.

The procedure was performed on an 11-year-old boy who had kidney obstruction, reported The Pioneer.

The boy, whose family lives in the northern city of Ludhiana, had been suffering from the problem since 2013. 

PGIMER did not immediately return’s request for comment. 

There has been a great deal of controversy surrounding robotic surgery in children in the US.

Proponents say these robotic surgical systems have better flexibility, magnification, and no fulcrum effect, which is when the ends of a surgical tool move in the opposite direction to the surgeon’s hands. 

But a 2015 study led by Akron Children’s Hospital in Ohio noted several limitations including the size and length of the instruments not being small enough for neonatal surgeries, slow learning curves, and higher costs for the procedure and the surgical system itself when compared to conventional surgeries. 

The study also said that complications following robotic surgery have been underreported in both medical literature and the news. 

Another 2015 study found the robotic surgeries were linked to at least 144 deaths and more than 1,000 injuries between 2000 and 2013 in the US.

Some of the incidents it listed included broken or burned parts falling into patients’ bodies, machines that suddenly turned on or off, electrical sparks that charred or burned body tissue, and video or imaging problems. 


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