Laparoscopy, by the 1990s, had become standard for many
urological procedures, but it had intrinsic limitations: two-dimensional
vision, limited instrument articulation, tremor, and surgeon fatigue,
especially in deep pelvic dissections. Robotic systems were developed to
overcome these barriers, offering new levels of precision and control. Robotic
systems combine the minimal invasiveness of laparoscopic surgery with enhanced
dexterity, three-dimensional magnified vision, tremor filtering, and ergonomic
advantages that preserve surgeon precision over long operations. In this
chapter, the study expands our understanding of robotics in Indian urology by
tracing its evolution and technological developments, examining its clinical
applications in both oncology and reconstructive surgery, exploring its
advantages and limitations, reviewing training and credentialing, and outlining
recent advances and future directions. Robotic technology has permeated nearly
every subspecialty of urology. Although its initial appeal was confined to
oncological surgery—especially prostate and kidney cancer—its role now extends
to reconstructive, functional, and even pediatric urology. The combination of
tele-robotics and indigenous cost-effective systems could make complex urological
surgery feasible even in government hospitals serving semi-urban populations.
Robotic platforms now integrate indocyanine green (ICG) fluorescence imaging,
which assists in vascular mapping during partial nephrectomy, delineating renal
vasculature and collecting systems. Indian surgeons increasingly use real-time
fluorescence to ensure complete tumour excision while minimising ischemia.
Author(s) Details
Vivek Meyyappan
Department of Urology & Renal Transplantation, Sri Ramachandra
Institute of Higher Education & Research, Chennai, India.
Velmurugan
Palaniyandi
Department of Urology & Renal Transplantation, Sri Ramachandra
Institute of Higher Education & Research, Chennai, India.
Hariharasudhan Sekar
Department of Urology & Renal Transplantation, Sri Ramachandra
Institute of Higher Education & Research, Chennai, India.
Sriram Krishnamoorthy
Department of Urology & Renal Transplantation, Sri Ramachandra
Institute of Higher Education & Research, Chennai, India.
Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-93-0/CH6
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