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Former Vattikuti Fellow Evaluates India's First Surgical Robot

23 March 2024

Dr. Kushal Agrawal, former VF Fellow, is part of a team from the Aster International Institute of Oncology who have produced two of the first reports on the SSI Mantra surgical robot published recently in the International Journal of Advanced Robotic and Innovative Surgery. He is the Corresponding Author for: Experience-based Procedure Card for Robotic-assisted Low Anterior Resection Using Indian SSI Mantra Robot. They report on procedures done on 32- rectal cancer patients who were operated on with the SSI Mantra robotic system.

Results are encouraging, here is a short excerpt: "With no open surgery conversions and positive outcomes in operative times, blood loss, and oncological measures, this resource aids surgeons in adopting robotic techniques for rectal cancer surgeries..."*

The journal article, according to the Authors, is the first to provide procedure cards for the SSI Mantra. It includes descriptions of port placement, as well as photos and diagrams of their team's set up of the SSI Mantra. In addition, photos are showing the instruments inside the body. The suggested procedural steps for Low Anterior Resection are also included. Here is the link for the complete article: https://journals.lww.com/iais/fulltext/2023/01020/experience_based_procedure_card_for.6.aspx

The second effort studied 50-endometrial cancer patients undergoing Modified Radical Hysterectomy with Indocyanine green (ICXG) Dye-based Sentinel Lymph Node Biopsy.

The team was led by VF Mentor Surgeon Dr. Somashekhar SP.
From the Abstract:
"Endometrial carcinoma ranks as the fourth most prevalent cancer among women in India. The use of robotic surgery in gynecological procedures was authorized by the FDA in 2005. SSI Mantra, an Indian robotic system, distinguishes itself with a 3D 4K panoramic camera and the advantage of seven degrees of robotic arm movement. Drawing from our experience, we developed a procedure card detailing a modified radical hysterectomy with sentinel lymph node biopsy using the SSI Mantra system." **

Recently, Dr, Agrawal presented his work at the SMRSC 2024 Conference in Delhi. He described some of his experience in a LinkedIn post: "A proud moment for Indian Healthcare! 🇮🇳 India takes a leap into the future with the introduction of its first surgical robot! The new SSI MANTRA innovation promises to revolutionize precision and efficiency in surgeries. Thrilled to have been a part of the SMRSC 2024 at Delhi, NCR. We have been using this system and it was a privilege to demonstrate a live surgery from Bangalore on the SSI robot. Definitely an innovative experience to say the least! The SSI Mantra is not only technologically advanced but it is affordable and accessible at the same time. The system has abilities to teleproctor and promises to launch telesurgery in near future. It was a wonderful opportunity to be a part of introducing such groundbreaking technology that is “Made in India- For the world.” (Dr. Kushal Agrawal at SMRSC 2024-courtesy LinkedIn)

The reports were both published in the International Journal of Advanced Robotic & Innovative Surgery. The team was led by VF Mentor Surgeon Dr. Somashekhar SP. From the Abstract: "Endometrial carcinoma ranks as the fourth most prevalent cancer among women in India. The use of robotic surgery in gynecological procedures was authorized by the FDA in 2005. SSI Mantra, an Indian robotic system, distinguishes itself with a 3D 4K panoramic camera and the advantage of seven degrees of robotic arm movement. Drawing from our experience, we developed a procedure card detailing a modified radical hysterectomy with sentinel lymph node biopsy using the SSI Mantra system." *

In addition, Kushal Agrawal tells the Vattikuti Foundation: "Yes, we have been using Indian Robot for some time now. The technology is new. There are some limitations, but they are acceptable considering the resources and cost at which we are able to provide the advantage of robotic surgery to many patients. We have compared our results on SSI Mantra with our own results on Da Vinci and with the initial experience we are able to get the same outcomes in terms of hospital stay and recovery."

In part, their conclusion states: "Our experience with the SSI Mantra robotic system for robotic Type I Modified Radical hysterectomy with ICG‑based SLNB has yielded promising results." Here is the link to the second journal article: https://journals.lww.com/iais/fulltext/2023/01020/experience_based_procedure_card_of_robotic_type_i.5.aspx

Look for more on the SSI Mantra in the future on the VF Website.

Publication information:

*Somashekhar SP, Agrawal K, Ashwin KR, Kumar CR, Dixit J, Fernandes AM, et al. Experience‑based procedure card for robotic‑assisted low anterior resection using the Indian SSI Mantra Robot. Int J Adv Robot Innov Surg 2023;1:70-4.

**Somashekhar SP, Voleti S, Ashwin KR, Kumar CR, Dixit J, Ahuja V, et al. Experience‑based procedure card of robotic type I radical hysterectomy with indo cyanine green dye sentinel lymph node biopsy using SSI mantra Indian robotic system. Int J Adv Robot Innov Surg 2023;1:65-9.