Prof Dr. Subhash Khanna, Dean of Swagat Academy of Medical Sciences, Assam and the Past President and present Trustee of Indian Association of Gastrointestinal Endo Surgeons (IAGES), is amongst the leading pioneers of laparoscopic surgeons of Northeast India. A nominee of the prestigious Dr. B.C. Roy National Award 2017 and recipient of several prestigious honours, Dr Khanna is credited with introducing Robotic surgery in the North-East India. An eminent teacher and a dedicated social worker, he is in the forefront of educating young surgeons of the country in MAS techniques, and shares his experience as to why Robotic Surgery is a disruptor in the medical domain.
As a pioneering GI practitioner, what are the areas of medical expertise that you have introduced in the Northeast?
It was my desire to see that the people of my state live a healthy life and get the best of medical treatment. This started the journey that went on to become my life’s mission and after completion of my medical education and specialised courses. I took the initiative to introduce advanced laparoscopic surgery, ERCP, NBI, Spyglass Cholangioscopy, Endoscopic Thyroidectomy, Bariatric surgery, VAAFT and Robotic Surgery for the first time in the North-east. As past president of Association of Surgeons of Assam, I got enthusiastic support to further the latest techniques in surgery by my fraternity. Since then, there has been no looking back. My leadership roles in different medical forums and institutions and my teaching experience as Professor of Surgery at Gauhati Medical College and Honorary visiting Professor of Surgical Gastroenterology of GSL Medical College has enabled me to take on greater responsibility for expanding the reach of these treatments to rest of the sister states of the region and the country. I feel humbled by the overwhelming response and impact of my work. I could pursue my passion with single-minded dedication largely because of my wife Prof Dr Swagata Khanna, an ENT Surgeon, both sons Dr Angshuman, an Orthopaedic Surgeon, Dr Ayushman, a Critical-care Specialist and daughter-in-law Dr Chaitra, a Colorectal Surgeon, all of whom are doctors by profession, and have wholeheartedly supported me thorough every challenge and cheered my success.
What makes you believe that robots are a game changer in medical profession?
One must understand that technology is now all pervading and healthcare is no exception. We owe it to technology that surgical intervention has become efficient, precise, quick and neat. Robotic surgery especially with the VERSIUS Robotic System is an outstanding example of advancement in technology which has changed the way complex surgeries are being conducted, and so it is truly a game changer. The added benefit is that eventually robotic surgery is going to be cost-effective proving to be a win-win situation for all stakeholders.
What are the kinds of medical robots available in India?
The latest robot is called Versius® and is marketed by CMR Surgical of Cambridge, UK. In India, VERSIUS has about 13 installations and we in Guwahati (Assam) are the first to have the Versius Robot in the Northeast region. There is only one other robot called Da Vinci following its approval by FDA in 2000. I do about 1000 Endo-Laparoscopic procedures in a year of which 10% are Robotic, which needs practice to master the technique of operating with it and that comes by handling increased numbers of cases. Technology upgradation is rapid, which means newer versions of the robots will roll out from time-to-time. I am absolutely sure that technology and robots are going to be there, and it is for the benefit of the society.
What makes robotics surgery more superior?
The advantages of robotic surgery are many. The most important aspect here with the Versius Robot is that it offers high-definition 3D visual of the organ or body part, which enables surgeons to see, reach and repair or remove the diseased part in the deepest crevices or crease of the body. The sutures too can be neatly done by keenly observing the image on the monitor or visual panel. The outcome of
robotic surgery is that it minimizes infection, is less painful, saves on time, enables early recovery and re-admission rate due to any post-surgery complications, is negligible. For the doctors robotics has proved to be ergonomically comfortable increasing their efficiency equivalent to two doctors. Most of the patients are discharged on the 2nd – 3rd day, which means more patients can be attended too and
treated at affordable cost.
However, it is necessary to train more doctors and build a competent team for best result.
What are your plans for installation of robots in other parts of the North-Eastern regions?
Our endeavours are motivated by the desire to treat people with the best and latest techniques for which robotic surgery facilities need to be installed. Initially, we have counselled patients to overcome apprehensions on being operated by a robot, but when the good word spread about the high success rate of such surgeries, it led to significant increase in acceptance. Also, literacy is very high in states such as Nagaland, Mizoram, Manipur and others, which is encouraging for us. These regions are going to come up in a big way as robotic medical hubs. I have brought Guwahati on the map of India in Robotics with the Versius Robot, and as Trustee and past President of IAGES and Vice President of International College of Surgeons. I am conceptualizing to provide training of Robotic surgery to surgeons of the Northeast and also rest of the country, and have started visiting different states of the country as part of my work ambit.
This may sound incredulous, but in Bangladesh there is not even a single robot! I have been invited by the neighbouring countries to establish robotic centres there and of course to train surgeons. I believe Technology reaches its zenith once it reaches the masses.
What are the different programmes conducted by you for the outreach medical fraternity?
In the last 30 years, I have done over 40 educational programmes and live workshops; have held seminars regularly and prepared curriculums for different courses. I am doing a number of online, offline and onsite teaching and training programmes. Currently, I am conducting a course on endoscopy for CBD stones (ERCP) where more than 25 surgeons from 24 states have joined for online training and they will be coming for hands-on training once the Covid is over. During the COVID-19 pandemic, I was involved as an advisor to the Government’s Arogya Nidhi programme, were we advised them on how to spend the funds and also, I was the In-charge of COVID Task Force of IAGES. I have delivered over 180 CME lectures and orations and regularly contribute chapters in journals and publications. As the Chief Editor of “Recent Advances in Minimal Access Surgery” and “International Academic Co-ordinator of IAGES” and as the Editor of Flexible Endoscopy “Journal of Minimal Access Surgery, I promote my areas of specialization in robotics by giving inputs to doctors and surgeons.
Finally, if I put into simple words my outlook for deploying Robotic Surgery; I shall say that a Robot delivers to a patient the experience of being operated on by a senior surgeon, through the hands of a young surgeon.
Prof Dr Subhash Khanna
MS, FRCS Edn, FICS, FALS, FAGIE.
Chief, Department of GI, Minimal Access and Robotic Surgery
Swagat Super Speciality Surgical Institute, Guwahati, Assam
Contact Details: profsubhashkhanna@gmail.com / Log on to www.swagathospitals.in