Dr Sharifah is a maestro when a woman faces a complex gynaecological case that demands both surgical artistry and high-tech finesse. Her blend of decades of care, advanced robotic skill, and heartfelt compassion sets her apart in the field.
00:00I am Dr. Sharifah Halima Jaafar and I am endometriosis subspecialist currently working in the hospital Picasso.
00:20What is a robotic surgery?
00:26The advantage for in gynecology, as compared to minimally invasive surgery, it has enhanced 3D visualization.
00:38So when we see, we see in the 3D and we can actually enhance it in multiple times.
00:43And then also the instrument that we use, it is wristed.
00:47So this is a robotic arm, so they have wristed something like this.
00:51So look at the end here, they actually wristed.
00:53So wrist, they have really mean that the end here can move to 360 degree.
00:57So we operate like this, we operate with our hands, right?
01:00So it just like can open surgery, but it's a minimally invasive in the abdomen.
01:05So because of that, it is very precise, we can control it very well.
01:10And then it also reduces the tremor.
01:12Because sometimes the surgery is very long, the robot actually can filter our tremor.
01:17So it's very precise, safe, and it has a better outcome.
01:20Because it is minimally invasive, so it gives the patient a faster recovery, less tissue injury, and then less painful, and also minimal complications.
01:33I think the most important thing is that for patient who require fertility enhancement, so they are better.
01:43And then we can give fertility sparing, and also nerve sparing.
01:47So they can go home, and then not only that, you know, they can return to activity faster, you know, not just going back to work.
01:50So they can go home, and then not only that, you know, they can return to activity faster.
01:54You know, not just going back to work, but in India, every day today, leaving their house course, and so they can actually perform it so much.
02:01And so they can actually perform it so much.
02:03So much advantageous as compared to minimally invasive.
02:05So, according to the studies, most of our patients, they feel less painful.
02:07And then, of course, both or so has a shorter stay.
02:08Actually, it requires just one day after the surgery the next step.
02:09So they can go home, and then not only that, you know, they can return to activity faster.
02:13You know, not just going back to work, but in India, every day today, leaving their house course, and so they can actually perform it so much earlier.
02:29You know that we have almost the highest numbers of robot in Malaysia as compared to the whole Southeast Asia combined, and also we have almost 20 robots now deployed in the whole country,
02:42as compared to 59, you know, in Southeast Asia.
02:45So it means that we still have the largest shares, and then we have more and more surgeons now being trained as robotic surgeons,
02:53not only in Europe, but also in gynecology.
02:57Right now, in Malaysia, you know, in fact, in Southeast Asia, the training is still very industrial-led training.
03:04So we have not got actually a common pathway for training robotics.
03:10So, of course, the training, you know, involved usually in four steps.
03:16So, of course, the first step will be observation, and then after that, they need to learn about that robot system itself, right?
03:23You know, so where they need to do a lot of simulation-based learning on the robot.
03:29So after they have passed this, you know, the simulation, the coordination, okay, by the industry, and they go for the lab training.
03:39So then they will go for the actual patients.
03:42So when the actual patient, they need to be proctored.
03:46So it means they have to be proctored by the experts in the robotics, you know, so to do the actual patient,
03:53and that also required a certain number before they can be allowed or maybe passed to do on the patient independently.
04:04It will take time, you know, it can be up to three months, you know, it can be up to six months to some people, you know, but some people can be even earlier.
04:11Of course, you know, there's a lot of more modification in the future and in the current now, right?
04:21But now the robot is very bulky, right? So eventually they will become slimmer and become more sleek.
04:27And then, you know, then now we have multi-pods, so maybe in the future it will be single-pods.
04:32They're already single-pods actually, but maybe not widely used, but it's already there, you know, single-pods.
04:41The robot is not a trend, it's not a height, but it's a tool to make our surgery better.
04:49It doesn't teach us how to do surgery, but for those who already did surgery, for the expert, it made you a little bit more expert,
04:56more precise, give you more quality. So this is what robot is all about.
05:00That's why it is not needed for all cases because we can do best also in many cases.
05:05But it's best to be done or maybe very valuable in complex surgery when laparoscopic surgery are more difficult,
05:13and then this will give us a better outcome, more safer surgery, and with more complete surgery, especially in cases of deep endometriosis.
05:21We have to use this responsibly, okay, because it's a higher cost on the patient, so it means that it must be a proper case selection.
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