Robotic surgery set to transform medical care in the Gulf

The Gulf region, and particularly Saudi Arabia, has become a world leader in the application of medical robotics. (Shutterstock)
Updated 10 July 2019
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Robotic surgery set to transform medical care in the Gulf

  • Technological advancements helping surgeons perform complex procedures using minimally invasive techniques
  • In robot-assisted surgery, the surgeon sits at a console and views the patient's target anatomy in HD 3D image

DUBAI: When it comes to man versus machine, many industries, including medical science, are at a critical juncture. 

Advancements in technology are creating a world where robots are performing tasks with speed and efficiency unmatched by their human counterparts.

Increasingly, robots are becoming a familiar presence in operating theaters, especially in the Gulf. Experts predict that the region could become the leader in the field of robotic surgery.

In June, Johns Hopkins Aramco Healthcare (JHAH) — the result of a joint venture between Saudi Aramco and Johns Hopkins Medicine — became the first hospital in the Kingdom to perform a robot-assisted hysterectomy.

“The new trend in hospitals that provide the most up-to-date medical services to their patients is to do surgical procedures using minimally invasive techniques,” Dr. Tareq Al-Tartir, a urologic oncologist and head of JHAH’s robotics program, told Arab News.

“Robotic surgery has revolutionized the way surgery is being conducted, and now many hospitals in Saudi Arabia have adopted this technique.”

Saudi surgeons are conducting increasingly complex procedures using the Da Vinci surgical system, said Al-Tartir.

The device features a set of three or four robotic arms remotely controlled by a human surgeon. 

IN NUMBERS

  • 2002 - The year robotic surgery was introduced. 2003 - The year a surgical robot was first brought to Saudi Arabia.
  • 44 - Da Vinci surgical systems installed in the Middle East.
  • 19 - Da Vinci surgical systems (pictured below) installed in Saudi Arabia.
  • 930 - Documented robot-assisted procedures performed in Saudi Arabia in 2004-2010.
  • 60% - Jump in robot-assisted procedures in 2011-2017.

Using the Da Vinci system, operations can be done with just a few incisions and the utmost precision, with less bleeding, faster healing and reduced risks of infection.

“At the beginning, robotic surgery was installed in a few institutes in the Middle East. The expertise needed to perform the procedures using the robotic machine developed with time. Currently, more institutes and more procedures are using the machine,” said Al-Tartir.

“The JHAH robotic surgery program is considered among the leading ones in the Middle East using this high-tech machine.” 

In the JHAH case last month, Al-Tartir said, the “hands” of the Da Vinci surgical system used to perform the hysterectomy allowed a high degree of dexterity. 

Thus surgeons had the ability to operate in very tight spaces, for example the pelvis, which would otherwise only be accessible through open surgery with long incisions.

During such surgery, the surgeon sits at a console and views the patient via high-definition 3D imagery, and manipulates the robotic arms through their own hands and wrists.

The system can be used on a range of minimally invasive surgeries, such as cardiac, urologic (including prostate, bladder and kidney cancers) and thoracic surgery.

JHAH has also carried out the first robot-assisted operations in the Kingdom to remove cancerous tumors. 

Its doctors, based in Saudi Arabia’s Eastern Province, were also the first to perform bariatric surgery and treat gastroesophageal reflux using similar techniques.

Al-Tartir said thanks to the JHAH’s program and the willingness of the Saudi government to invest in medical care as part of its Vision 2030 reforms, the Kingdom is capable of putting the Gulf region on the map of robotic-assisted surgery.

“The ability of young surgeons to digest this new technology is a well-known fact, and the world trend now is to move into digital transformation. Medicine in general, and surgery in particular, is part of that trend,” he added.

“In the coming few years, robotic surgery will be the new gold standard in doing surgical procedures, and countries like Saudi Arabia, which invests a significant part of its income on the health of its citizens, can become a leader in this field.”

According to a study titled “The Development of Robotic Surgery in the Middle East,” led by King Saud University, robotic surgery started gaining a foothold in the region in 2003, about three years after Da Vinci became the first robotic surgery system approved by the US Food and Drug Administration for general laparoscopic surgery. Saudi Arabia was the earliest adopter of the technology in the Middle East.

The Kingdom already has 14 Da Vinci surgical systems, each coming with a price tag of more than $2 million, Al-Tartir said. 

“Surgeons across all regions in Saudi Arabia are putting all their efforts into using this technique,” he added.

“The benefits include better magnification with better visualization, low risk of blood loss, lessened need for blood transfusions, less pain and scarring because of the use of small incisions to perform complex surgical procedures, reduced hospital stays and speedier recovery.”

While Da Vinci surgery, developed by the US company Intuitive Surgical, is considered a medical leader, many big tech companies are developing their own autonomous systems.

CMR Surgical, a British medical device company, is rolling out its offering “Versius” which, like other surgical robots, performs laparoscopic surgeries.

Surgical robotics are “a key enabler for increasing access to minimal access surgery and keyhole surgery,” Dr. Mark Slack, chief medical officer at CMR Surgical, told Arab News.

But despite its numerous proven benefits over open surgery, this technique is utilized in less than half of all procedures worldwide.

“This means many thousands of people each year are more likely to be subjected to the disadvantages of open surgery, including increased pain, surgical site infections and a range of surgical complications. This also creates a burden of long stays in hospital and significantly longer recovery times,” Slack said.

The scope for countries willing to invest in the robotic medical field is endless. But though the march of technology may be relentless, surgeons need not worry about robots taking their jobs. 

“Surgical robotics, including Versius, have been designed to be a tool to be used by surgeons, and therefore the relationship between surgeon and patient doesn’t change,” Slack added.

Dr. Rakesh Suri, CEO of the Cleveland Clinic Abu Dhabi (CCAD) and head of its robotic cardiac surgery program, said a common misconception is that robotic surgery does not involve the surgeon.

“In fact, the robot acts as an extension of the surgeon, enabling us to perform operations in a way that simply wouldn’t be possible with human hands. The robot allows us to manipulate surgical tools with unparalleled precision,” he told Arab News.

“Robotic surgery is of most benefit in densely packed and awkward areas of the body that present significant risks through traditional approaches,” he said.

“Because it’s minimally invasive and the robotic arms are so precise, we can access specific sites with minimal damage to the surrounding area,” he added.

“This helps patients recover significantly faster with fewer complications, improving outcomes and costs for health systems as a whole.”

Currently, robotically assisted procedures are most commonly used in urological procedures, said Slack. 

But forecasts predict strong expansion across gynaecology, general surgery and upper gastrointestinal surgery, meaning many now-common surgical procedures could soon become obsolete.

Suri said robotics play a key role in dealing with some of the leading health care challenges in the Middle East.

“As we deal with rising rates of cardiovascular disease, obesity and cancer, robotic surgery will only become more important in offering patients the best possible outcomes, and eliminate the need for patients to travel abroad for treatment,” he added.

“To meet that challenge head on, it’s vital that the Middle East is able to build on its potential to become a leader in the field of robotic surgery globally.”

 


Sofia Boutella dazzles at London ‘Rebel Moon’ screening

Updated 20 April 2024
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Sofia Boutella dazzles at London ‘Rebel Moon’ screening

DUBAI: French-Algerian actress Sofia Boutella turned heads at the UK premiere of her film “Rebel Moon — Part 2: The Scargiver” in London this week.

Boutella wore a black suit from British fashion designer Stella McCartney with a cropped satin blazer and low-rise straight-leg trousers. She styled her short, dark hair in loose waves, complemented by dramatic cat-eye makeup.

In the sci-fi adventure — a sequel to last year’s “Rebel Moon — Part One: A Child of Fire” — which debuted on Netflix April 19, a peaceful colony on the edge of a galaxy finds itself threatened by the armies of a tyrannical ruling force.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

A post shared by Sofia Boutella (@sofisia7)

Kora, played by Boutella, has assembled a small band of warriors — outsiders, insurgents, peasants and orphans of war from different worlds who share a common need for redemption and revenge, and must band together to fight the Motherworld.

Snyder previously spoke about the two-part epic space opera at Netflix’s Tudum global fan event in Brazil, where he showcased a behind-the-scenes look into the making of the film, based on a concept he has been developing since college.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

A post shared by Sofia Boutella (@sofisia7)

“I’ve been working on this story for quite a while,” Snyder said on stage, according to Deadline. “It’s about a group of farmers on the edge of the galaxy that get visited by the armies of the Motherworld, who are the bad guys. The farmers have to decide to fight or submit.”

He continued: “I don’t want to give it all away, but if they had decided to fight, let’s say that was an option, they would have to travel around the galaxy to find warriors to fight with them. And so, it had us traveling quite a bit.”

Kora is not Algiers-born Boutella’s first role as a sword-wielding extraterrestrial. The actress, who at the age of 10 fled to Paris with her family during the Algerian civil war, is known for her breakout performance in the Oscar-nominated film, “Star Trek Beyond,” in which she portrayed the fierce alien warrior, Jaylah.


Rami Kadi unveils dazzling couture collection in AlUla

Updated 20 April 2024
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Rami Kadi unveils dazzling couture collection in AlUla

DUBAI: Lebanese designer Rami Kadi presented his latest haute couture collection on Friday in AlUla with star-studded guests. 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

A post shared by Rami Kadi (@ramikadi_pvt)

His summer/spring designs offered something for everyone. The dresses showcased a variety of necklines, ranging from halter gowns and plunging V-shaped dresses to off-the-shoulder styles, strapless designs and more. 

The dresses, crafted from fabrics such as tulle, chiffon and crepe, exuded voluminous, glitzy and metallic aesthetics. However, there were also satin options and simpler designs available.

The collection boasted a palette of pastel hues including pink, peach, blue, green, purple, and an array of other colors such as off-white, beige, silver and gold.

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

A post shared by Rami Kadi (@ramikadi_pvt)

The show was a collaboration between Kadi and AlUla moments. It was attended by Lebanese superstar Najwa Karam, Saudi actress Mila Al-Zahrani, Tunisian actress Dorra Zarouk, and Saudi influencers Nojoud Al-Rumaihi and Lama Alakeel.


Hollywood Arab Film Festival: Showcasing Arab cinema in Los Angeles

Updated 20 April 2024
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Hollywood Arab Film Festival: Showcasing Arab cinema in Los Angeles

LOS ANGELES: The third annual Hollywood Arab Film Festival began this week, bringing the best of 2024’s Arab cinema to Los Angeles and giving fans a chance to see the films in theaters as well as introducing a new audience to the Arab world’s top talent.

The event, which runs until April 21, was attended by a number of celebrity guests including Egyptian producer and screenwriter Mohamed Hefzy, Tunisian actor Dhaffer L’Abidine, renowned Egyptian star Elham Shahin and Egyptian producer Tarek El-Ganainy.

At the event, Hefty said: “Arab cinema really needs a platform to tell our stories and to show who we are, our identity, our hopes and dreams, our pains, and all the different social topics that are tackled in some of the films that are being presented are maybe more relevant today than ever. So I think it’s a great opportunity to have this dialogue.”

Hefzy’s film “Hajjan” was showing at the event. It is a Saudi Arabia-based film directed by Egyptian filmmaker Abu Bakr Shawky.

“Hajjan is a film about a young boy who got a very special connection to his camel, who has a brother who was a camel jockey and races,” Hefzy said. “And, one day when something really unexpected happens to his brother, and shatters his world, it forces him to step into his brother’s shoes and become a camel jockey, and so starts racing himself.”

The movie is a co-production between the Kingdom’s King Abdulaziz Center for World Culture, or Ithra, and Hefzy’s Film Clinic.

“It was a film made in Saudi Arabia with Saudi talents and actors with an Egyptian director, but with the Saudi co-writer and Saudi actors and shot mostly in Saudi Arabia,” Hefzy said. “So I think it’s, it was a great experience, and learned a lot about Saudi Arabia, learned a lot about the culture.”

The festival featured cinema from various Arab countries, presenting films from 16 different nations. Marlin Soliman, strategic planning director of HAFF, highlighted the inclusion of six feature films, ten short films and six student films.

Spanning five days, HAFF offered its audience a vibrant experience, including a red-carpet affair, panel discussions on filmmaking and diversity in Hollywood, and, of course, screenings of high-profile films.

The festival also saw several filmmakers singing the praises of Saudi Arabia’s expanding film industry.

L’Abidine, the writer and director of “To My Son,” said: “I’m thrilled to be back again with my second feature film ‘To My Son,’ a Saudi film… I think there is a great evolution of Saudi cinema that’s been happening in the last few years.”


Dave Chappelle to perform at Abu Dhabi Comedy Week

Updated 19 April 2024
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Dave Chappelle to perform at Abu Dhabi Comedy Week

DUBAI: US award-winning comedian Dave Chappelle is set to perform in the UAE at the Abu Dhabi Comedy Week on May 23, organizers announced on Friday.

The capital city’s first-ever comedy festival will run from May 18-26 at Yas Island’s Etihad Arena.

Chappelle will join a long list of comedians performing at the event, including Chris Tucker, Aziz Ansari, Tom Segura, Jo Koy, Tommy Tiernan, Kevin Bridges, Andrew Santino, Bobby Lee, Andrew Schulz, Bassem Youssef and Maz Jobrani.

With numerous accolades and awards to his name, including multiple Grammy Awards and Emmy Awards, Chappelle is renowned for his wit and fearless commentary on contemporary issues.

While May 23 will mark Chappelle’s inaugural performance in Abu Dhabi, he has previously captivated audiences with two sold-out shows in Dubai.


Manal AlDowayan on her work for the Venice Biennale 

Updated 19 April 2024
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Manal AlDowayan on her work for the Venice Biennale 

  • The acclaimed artist is representing Saudi Arabia at this year’s ‘Olympics of the art world’ 

DUBAI: The acclaimed Saudi artist Manal AlDowayan is on a roll. Earlier this year, she opened two well-received exhibitions in AlUla, where she is also working on an ambitious land art commission for the upcoming Wadi AlFann cultural destination. And this week, AlDowayan will represent her country at the 60th iteration of the Venice Biennale — dubbed “the Olympics of the art world,” consisting as it does of multiple national pavilions — which runs until Nov. 24. She will be presenting what she describes as “two of my most major works in my career at this point.” 

AlDowayan has participated at Venice before. In 2009, she showed her work in an onsite exhibition organized by the Saudi art-focused initiative Edge of Arabia, alongside fellow Saudi artists including Maha Malluh and Ahmed Mater.  

AlDowayan will represent her country at the 60th iteration of the Venice Biennale. (Supplied)

“I’ve been going to Venice for about 12 years,” AlDowayan tells Arab News. “The first time I showed there, I knew in my heart that I would be coming back to represent Saudi Arabia; I would do everything in my power to come to this moment and prepare myself. It’s something very important for an artist: to participate in the Venice Biennale.” 

It was only last August that she was visited in her UK studio by Dina Amin, the CEO of the Visual Arts Commission, and cultural advisor Abdullah Al-Turki, and told she had been selected to represent the Kingdom in 2024.  

“My first thoughts were: ‘There’s no time,’” she says with a laugh. “To come up with a concept, complete the research, execute the concept, build it, and install it, is really complex. But my team, my studios, and I were ready. I already knew what I wanted to present, and within one week I had put together my proposal and it was approved. The artwork is a continuation of my language, my research and my forms that I work with.”

Participatory workshops for 'Shifting Sands - A Battle Song' by Manal AlDowayan. (Supplied)

The Saudi pavilion’s theme at Venice this year is “Shifting Sands—A Battle Song.” It is curated by a trio of female art experts, Jessica Cerasi, Maya El-Khalil, and Shadin AlBulaihed. In AlDowayan’s sound-meets-sculpture installation, she brings together much of what she has explored in her practice over the past two decades — community engagement, participatory art, media (mis)representation, and the visibility, or lack of it, of women in Saudi culture. The work is also about the momentous changes taking place in the Kingdom today, and her response to them.  

The work comprises two key parts: sound and soft sculptures. Saudi and Arab women’s voices are front and center; AlDowayan allowing them to reclaim their narrative, which she believes has consistently been misrepresented.  

“If you’re always told that you’re oppressed, repressed, depressed… you sort of lose the sense of yourself,” she adds. “And this artwork talks about this sort of constant hounding by Western media — and local media — speaking about the Arab woman; her body, her space, the rules of her behavior, and how she should exist in the public space.” 

Manal AlDowayan's 'Shifting Sands - A Battle Song.' (Supplied)

For this section, AlDowayan put out an open call inviting women to take part in workshops. They proved very popular, attended by all ages, professions and backgrounds.  

“In Riyadh, within three hours, 350 women registered,” she says. “We had to block the registration link because I don’t know how to control 350 women. I’m just one.” In the sessions, participants reacted to negative press headlines and media clippings, and AlDowayan recorded those reactions.  

“I always say that people are trying to define what a Saudi woman is,” explains AlDowayan. “We researched thousands and thousands of articles in my studios, in seven languages, and there were some very dark things written. I showed the women these articles and said, ‘Do you really feel these articles are really speaking your truth?’”  

She also asked them to write and/or draw their own stories. Examples included: “Two women equal one man.” “Thanks love, we don’t want to be saved.” And “Surrendering doesn’t look good on us, for we are wars.”  

Detail from Manal AlDowayan's 'Shifting Sands - A Battle Song.' (Supplied)

A selection of the written quotes were then read out loud by participants. While reading, they had headphones on, listening to, and harmonizing with, the eerie humming sounds made by sand dunes, which AlDowayan had previously recorded.  

“It was beautiful and meditative. You will see women with their eyes closed, their arms stretched out. It was a very spiritual moment,” AlDowayan recalls. The whole ‘performance’ was inspired by ‘Dahha,’ a ritual in which warriors celebrated victory with music and dance.  

Inside the pavilion, where the women’s recordings play, stand three soft black-and-brown sculptures, full of folds, shaped like the sand crystals known as desert roses — a recurring motif in AlDowayan’s work.  

“The rose is a very weak and delicate (thing),” she says. “But this crystal is born in extreme circumstances. First, it needs to be pouring rain, then there needs to be high temperatures and that’s how it crystalizes. I feel like I’ve adopted this form as a body and I deal with it like skin.”  

The folds of the enlarged sculptures are imprinted with “a cacophony of what Western media has written: the veil, repressed, oppressed, women, sexuality… All the words that always float over our heads,” says AlDowayan. They also include some of the women’s positive messages, as well as their drawings.  

“While you’re taking this journey you will hear the sound, and sound is sculptural in my opinion: It occupies but you can’t see it,” she says. “I feel the invisibility of sound, and its ‘presence’ is like the Arab woman. She’s strong, she’s there; it’s undeniable. Just because you don’t see her, it doesn’t mean she doesn’t exist.” 

As for how visitors will react to her work, AlDowayan hopes to provoke conversations.  

“I want questions. I want extreme emotions. They can hate it, they can love it, they can cry. But, I can’t do neutral,” she says. “Neutral means I did not succeed. If they have questions, then I’ve succeeded. If they talk about it after one day, I’ve succeeded.”