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.”

 


‘Bridgerton’ actress says she was warned not to campaign for Palestinians

Updated 26 April 2024
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‘Bridgerton’ actress says she was warned not to campaign for Palestinians

  • Nicola Coughlan: Hollywood insiders told her advocacy could harm her career
  • Irish star feels ‘moral responsibility’ to campaign for ceasefire, continue to fundraise 

LONDON: Irish actress Nicola Coughlan has revealed that she was told her Palestinian advocacy could harm her career.

The “Bridgerton” and “Derry Girls” star told Teen Vogue she had been warned by people in Hollywood not to be openly supportive of Palestinian rights, but has continued to campaign for a ceasefire in Gaza and still publicly wears an Artists4Ceasefire pin.

“You do get told, ‘you won’t get work, you won’t do this,’ but I also think, deep down, if you know that you’re coming from a place of ‘I don’t want any innocent people to suffer,’ then I’m not worried about people’s reactions,” she said.

“My family lived in Jerusalem back in the late ‘70s, early ’80s, before I was born, so I heard first hand stories about them living there.”

She said her father, who served in the Irish military, went to a “lot of war-torn regions after the conflict and try and help rebuild,” and this had left a profound impression on her.

“I’m so lucky I’ve gotten to this point in my career, and I’m privileged as a white woman, first off.

“Then the fact that I get to do the job I love and travel the world and meet amazing people, I feel a moral responsibility to give back.”

She has made a point of continuing to campaign and raise money around the issue, adding: “To me, it always becomes about supporting all innocent people, which sounds oversimplified, but I think you’ve got to look at situations and just think, ‘Are we supporting innocent people no matter where they’re from, who they are?’ That’s my drive.”

Coughlan said social media plays a role in driving advocacy but it requires nuance. “More of us should be trying to understand how upsetting and traumatising this is for Jewish people, and how horrific it is that all these innocent people in Palestine are being murdered,” she added.

A number of Hollywood figures have faced repercussions for their open support of the Palestinians or criticism of Israel.

Mexican actress Melissa Barrera was fired from the latest “Scream” film over social media posts in support of Palestine, while director Jonathan Glazer caused controversy for using his acceptance speech at the Oscars for his film “The Zone of Interest” to criticize the Gaza war.


‘Game of Thrones’ star Liam Cunningham says world will ‘not forget’ those who stayed silent on Gaza

Updated 26 April 2024
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‘Game of Thrones’ star Liam Cunningham says world will ‘not forget’ those who stayed silent on Gaza

  • Irishman has been vocal advocate for Palestinian causes for decades

LONDON: Irish actor Liam Cunningham has said the public will “not forget” those who have not voiced support for Palestinians during the ongoing Israel-Hamas conflict in Gaza.

The “Game of Thrones” star has been a vocal advocate for Palestinian causes for decades. Speaking during a demonstration in Dublin led by Irish-Palestinian Ahmed Alagha, who has lost 44 family members in the recent Israeli assault on Gaza, Cunningham said he has been commended by his peers in the past for his activism.

“What concerns me is that the people who do care and are not doing anything are, in my opinion, worse than the people who don’t care,” he said.

Cunningham was asked if he had spoken to other actors to convince them to show support for the Palestinian cause, but responded by saying he could not speak for others, The Independent reported.

However, he added, “The internet doesn’t forget. When this comes around, when the ICJ (International Court of Justice) and ICC (International Criminal Court) hopefully do their work honorably, it is going to come out,” he said.

“And the people who didn’t talk — it is not going to be forgotten. It’s livestreamed, this genocide, and (saying) you didn’t know is not an option. You did know. And you did nothing. You stayed quiet. I need to be able to look in the mirror, and that’s why I speak,” he added.

A month after Israel launched its onslaught on Gaza in response to Hamas incursions on Oct. 7 in Israeli territory in which nearly 1,200 people were killed and around 250 hostages were taken, Cunningham said that for Irish people to ignore the treatment of Palestinians would be to “betray” their history.

“If we allow ourselves to accept this behavior, then we allow it to happen to us,” he said at the time. “We have to stand up for standards. We have to stand up for international law and it reduces us as human beings if we don’t.”

Israel’s assault on Gaza has killed more than 34,000 Palestinians, around two-thirds of them children and women, according to Hamas-run health authorities in the enclave.


Saudi Film ‘Hajjan’ wins 6 nominations at Critics Awards for Arab Films

Updated 26 April 2024
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Saudi Film ‘Hajjan’ wins 6 nominations at Critics Awards for Arab Films

DUBAI: Saudi Arabia-based film “Hajjan,” directed by Egyptian filmmaker Abu Bakr Shawky, is nominated for six categories at the eighth Critics Awards for Arab Films.

The movie is competing in the best feature film, best screenplay, best actor, best music, best cinematography and best editing categories. 

“Hajjan” tells the story of Matar, a boy who embarks on a journey across the desert with his camel, Hofira.

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

The movie, which is written by Omar Shama from Egypt and the Kingdom’s Mufarrij Almajfel, stars Saudi actors Abdulmohsen Al-Nemer, Ibrahim Al-Hsawi, among others. 

The awards ceremony, scheduled for May 18 on the sidelines of the Cannes Film Festival, is organized by the Arab Cinema Center in Cairo and assessed by a panel of 209 critics representing 72 countries. 

Sudanese director Mohamed Kordofani’s inaugural feature film, “Goodbye Julia,” and Tunisian filmmaker Kaouther Ben Hania’s Oscar-nominated documentary, “Four Daughters,” scored nominations in seven categories. 

Jordanian filmmaker Amjad Al-Rasheed’s “Inshallah A Boy” and Palestinian-British director Farah Nabulsi’s “The Teacher” have six nominations.


Emirati designer Hamda Al-Fahim dresses Anya Taylor-Joy for Tiffany event

Updated 26 April 2024
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Emirati designer Hamda Al-Fahim dresses Anya Taylor-Joy for Tiffany event

DUBAI: US actress Anya Taylor-Joy this week was spotted at the Tiffany & Co. celebration of the launch of Blue Book in Beverly Hills wearing a dress by Emirati designer Hamda Al-Fahim.

The actress from “The Queen’s Gambit,” who is the ambassador for the American luxury jewelry label, impressed her fans in a head-turning dark golden brown dress that featured a corset-styled bodice paired with a fitted velvet skirt that flowed down, culminating in a short train trailing behind her.

The dress is called the Velvet Canyon and is from Al-Fahim’s Earthy collection.

Caption

Al-Fahim took to Instagram to share pictures of the star championing her design with her 498,000 followers.

“Anya Taylor-Joy (looks) stunning in our Velvet Canyon,” she wrote on her Stories. 

For her jewelry, Anya chose a glitzy diamond necklace embellished with red rhinestones, accompanied by matching earrings and a ring. She completed the ensemble with a statement chunky silver bracelet.

She styled her blonde hair with a side part, which cascaded in soft waves past her shoulders.

Taylor-Joy was accompanied by a star-studded lineup of celebrities, including Olivia Wilde, Emily Blunt, Gabrielle Union, Quinta Brunson, Rosie Huntington-Whiteley, Reese Witherspoon, Laura Harrier, Suki Waterhouse and Aimee Song, among others.

Wilde flaunted a black figure-hugging dress with a plunging neckline, Blunt was radiant in a white sequin dress, Union opted for a custom-made Staud dress in black and white, Brunson wore a black velvet midi-gown from Roland Mouret and Huntington-Whiteley chose a white Carolina Herrera dress.

Al-Fahim is an Abu Dhabi-based designer known for her elegant and ethereal aesthetic, often featuring intricate embellishments, delicate fabrics and flattering silhouettes. Her creations combine femininity and sophistication, blending traditional craftsmanship with modern sensibilities.

Seen on red carpets, premieres and high-profile events worldwide, Al-Fahim’s creations have captured the attention of international celebrities including Rihanna and Jennifer Lopez.

Al-Fahim has also previously teamed up with US luxury handbag designer Tyler Ellis on a limited-edition capsule collection in 2022.


REVIEW: Sofia Boutella’s heroic efforts can’t save ‘Rebel Moon — Part Two’

Updated 26 April 2024
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REVIEW: Sofia Boutella’s heroic efforts can’t save ‘Rebel Moon — Part Two’

DUBAI: “Rebel Moon — Part One: A Child of Fire” drew scathing reviews (our writer described it as perhaps “the most discombobulating collection of mismatched sci-fi tropes ever committed to film”). “Part Two: The Scargiver” simply adds to that legacy.

The story: Former Imperium soldier Kora and the surviving band of ragtag warriors she’s recruited return to the moon of Veldt — home to simple farming folk in danger of being blown to bits by the mighty Imperium for failing to supply the unreasonable grain quota demanded of them. With just a few days before the deadline, Kora and her band must train the villagers to fight (and harvest the grain in just three days to provide a bargaining chip). What Kora doesn’t know is that Admiral Noble, the bad guy she ‘killed,’ is still alive. And bent on vengeance.

Before the enemy arrives, the warriors tell their life stories in a trust-building exercise — one of the clunkiest pieces of exposition ever written. There are slow-mo shots of the harvest gathering and a brief interlude to show that Kora and farmer Gunnar are very much in love.

Then, thankfully, we’re into the battle(s). Here, at least, director Zack Snyder doesn’t disappoint, even giving an original twist to the ‘spaceship plummeting from the sky’ trope by staging a showdown between Kora, Gunnar and Admiral Noble on a floor that becomes increasingly vertical. Below them, the villagers fight heroically against odds very much stacked against them, even with the help of Nemesis and her two flaming definitely-not-lightsabers.  

The well-constructed battle scenes, though, aren’t enough. Not even with a cast fighting as heroically as the villagers to salvage something. Sofia Boutella, as Kora, emerges with most credit, proving herself a convincing action hero who deserves better than this material to work with (spoiler alert: perhaps even material that allows the heroine to kill the bad guy herself, without the intervention of her boyfriend).

Yes, no one’s sitting down to watch an “epic space opera” in the expectation of thought-provoking dialogue, but “Rebel Moon” is like the result of forcing a seven-year-old to watch all things “Star Wars” and “Star Trek” in random order, then asking them to write down what happened. The best thing to say about “The Scargiver” is that it finishes — but even that comfort is tainted by Snyder’s cynical setting up of a potential part three. Possibly because that seven-year-old fell asleep before writing an actual ending.