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Belizean Doctor Preforms the First Robotic Surgery in the Region

The Pandemic Papers is not the only international news that Belize has been featured in recently. As a matter of fact, one Belizean doctor was at the center of a medical milestone in the Caribbean. Doctor Shamir Cawich is a Belizean professor at the University of the West Indies and was part of a group of six medical professionals dubbed the “Trinidad Six” who conducted the first robotic-assisted surgeries in the Caribbean. The first such surgery was done on September 20 at the Port-of-Spain General Hospital with the assistance of the Freehand Panorama CoBOT. Dr. Cawich says the robot is used to assist with laparoscopic surgeries and procedures which involve the insertion of narrow tubes into the abdomen through small incisions. Via Zoom, Cawich, who now lives in Trinidad and Tobago shared the good news with the Belizean media.

Doctor Shamir Cawich : This at the turn of the turn of the 21st century was largely replaced and the type of surgery that we practice now is laparoscopic surgery. So you’ll see what happened we went from the mid 19th century where crude surgery was done to the mid 20th century to the late 20th century when there were big open incisions for open surgery and now in the 21st century this is what is practiced. This is laparoscopic surgery and this is my hand putting in a laparoscopic port into somebody’s tummy and through this we’re going to put a variety of instruments to operate.  Now I want you to notice that this instrument is about the width of my thumb so it’s very small and the instruments that we put in are going to be about the diameter of a regular pencil. So lots of small instruments with fine delicate teeth and then we’re gonna use this thing at the top which is a camera or a scope to put into the port so that we can see and perform the operation. So instead of the original photo I showed you where two big hands are inside you can see my hand here holding the instrument and our very tiny instruments smaller than the diameter of my finger goes in and this is how we do the operations. So this is an example of me removing a gall bladder and you can see me pinching the gall bladder neck here with my thumb and third finger but nowadays we do it like this with these laparoscopic instruments that do the same thing with much more accuracy, much more finesse and much better vision. And unlike the late 1900’s where surgeons would have to huddle together and look into an open cut and try to avoid the light so that they can see we don’t do this anymore we now stand upright as the surgeon and you can see all of us are looking toward a screen. But look at this, this is Dr.Mohanty assisting me he’s holding the camera, I’m holding the instruments and this is how we perform operations by looking at a screen to get visual feedback and perform these operations. And these operations are performed with regularity throughout the Caribbean even in Belize with pretty good outcomes.”

The operating surgeon communicates with the robot using a series of head gestures while wearing a headpiece and a controller by their foot. Dr Cawich says the mobility of the robot would allow it to be used at any medical institution within the public and private sectors.

Doctor Shamir Cawich : “We did four successful operations using this robot from as simple as removing the gall bladder to as complex as opening the bile ducts and removing stones in the liver. But it is an exciting advancement to the Caribbean as a whole. There are many advantages that the surgeon will have. One is that it gives you a hundred percent control so it removes the potential for human error by an additional person who has to hold the camera. It gives you steady and reliable vision and it’s very easy to use, as I said it follows my every command to a T and when that provides and advantage to surgeon it means that patients will benefit because there are improve outcomes for patients when operations are done in this manner and of course we’ve already talked about the benefits to the delivery of healthcare by providing better outcomes, by being COVID compliant and allowing us to deal with the staff shortages and will invariably occurs because of the response to the pandemic and even though these things I’m showing you are things in Trinidad and Tobago where I am based there is absolutely no difference to the response that’s gonna happen in Belize because you are also going to be going through the same staff shortages, the same use of staff for all of this time for the pandemic, the same delays in the operating list, the situation that we practice in is going to be exactly the same and so this is something that should also be beneficial to every single country in the English speaking Caribbean and that’s exactly what we hope. That this now will go right through the Caribbean and be adopted and used by surgeons locally in every Caribbean territory.”

Jamaica is expected to conduct its first robot-assisted surgery by the month’s end.