The Operating Room Rules That Don't Change With the Platform

Cost depends on the exact procedure. For endometriosis surgery, whether it involves removing the uterus or only a cystectomy changes the figure, but in Indian currency the cost is typically 4 to 5 lakhs, roughly 4,000 to 5,000 US dollars.

A basic surgical background is required. Admission into a robotic training course in India requires an MS in Obstetrics & Gynaecology or MS in General Surgery, with at minimum some exposure to procedures such as LSCS, so the surgeon understands the underlying operative anatomy and principles. Without that foundation, the transition is very difficult. Requirements vary by country, and it would be worth checking what pathways exist locally.

It is definitely possible to train in robotics directly, and many surgeons find it easier to learn than laparoscopic surgery, especially if they are already comfortable with open surgery. India has a three-step pathway supported by Intuitive: Level 1 is simulation-based certification, Level 2 requires 30 to 50 procedures completed independently or under supervision, and Level 3 is advanced training. There is no requirement to learn laparoscopy first, though prior exposure helps. Most surgeons gain confidence within a year of focused training, with a trained bedside assistant supporting the docking and undocking process.

Yes. BLK-Max takes two robotic fellows every year, one in surgical oncology and one specifically in gynaecologic oncology, each for a one-year fellowship in minimally invasive robotic surgical oncology. The full application procedure and selection criteria would be shared afterward through the Jivo Healthcare team.

Avoiding spillage is the single most important principle, particularly in oncological cases, because spillage of malignant contents can upstage disease and worsen prognosis. Liberal use of endobags is mandatory whenever malignancy cannot be excluded.

If intraoperative findings show a case cannot safely be completed robotically or laparoscopically, the guidance is to convert early and keep a low threshold for doing so, rather than pushing to preserve the minimally invasive approach.

Controlled aspiration with purse-string suturing is preferred over uncontrolled decompression for large benign masses, and port-site protection guards against tumour seeding at the trocar sites.

A frozen section facility should always be available when the preoperative diagnosis is uncertain, so intraoperative decision-making, including organ preservation in younger patients, can be made safely.