Asian Heart Institute, one of the leading cardiac care hospitals recently hosted a live robotic surgery course for treatment of obstructive sleep apnea (OSA), on two patients in the city. The workshop was conducted for doctors around the world to display the latest robotic technique called Transoral Robotic Surgery (TORS) of the base of tongue to treat OSA and was viewed real time by more than 2000 doctors from across the globe via a webcast.
OSA is a disorder in which a person stops breathing during the night, perhaps hundreds of times. These gaps in breathing are called apneas. The disorder occurs when tissues in the upper throat collapse at different times during sleep, thereby blocking the passage of air. The workshop attended by world renowned robotic surgeons for sleep apnea professor Dr Claudio Vicini, Dr Filippo Montevecchi from Italy, Dr Ramakanta Panda, VC and cardio-vascular thoracic surgeon, Asian Heart Institute and ENT surgeon Dr Vikas Agrawal who is credited to be the first Indian surgeon to perform this complex ENT procedure robotically and endoscopically in India.
This type of surgery is considered extremely challenging because the base of tongue is a very heavy muscle situated deep in the throat. “Both these patients were non obese and had tried the continuous airway pressure (CPAP) therapy however it did not benefit them. Studies suggest that obese people are four times more prone to obstructive sleep apnea syndrome, but now we are increasingly seeing even non-obese patients with severe OSA symptoms,” said Dr Agrawal.
Building on a 2009 AIIMS study with his observations, he added, "The number of the patients suffering from OSA is assumed to be strongly underestimated, studies suggest that the prevalence of OSA in the Indian population is 13 per cent and out of them only four per cent go to the doctor with the symptoms. Also the incidence is three-fold higher in men as compared to women."
Explaining why Indians are more at risk, Dr Agrawal elaborated that since faces of Indian are more flat with chin not as protruding as that of the Caucasians, resulting the tongue to press on the back of throat more frequently leading in continuous positive airway pressure (CPAP) mask which is not as effective in Indian population as Caucasians.
About the surgery Dr Vicini, a world renowned expert added, “TORS of the base tongue for treatment of OSA has many advantages over conventional CPAP therapy option which delivers air through a mask while the patient sleeps, keeping the airway open. TORS is extremely effective one time treatment for OSA as it gives extreme precision of robotic arm which resects the obstruction in the base tongue which is otherwise very difficult to reach as well as to operate due to its heaviness.”
Lending support to the activity, Dr Ramakanta Panda, VC and MD and chief cardio vascular surgeon, Asian Heart Institute added, “This live surgery course on TORS is a step towards honing the skills and expertise of the medical community who will benefit largely form this surgical knowledge sharing.”