In this episode of Genomics Gupshup, we speak with Dr. Abirami KJ — a pioneering surgeon at the intersection of robotics and genomics — about how these two transformative technologies are converging to reshape the future of healthcare. From robotic surgery guided by genetic insights to personalized cancer treatment, the conversation covers the cutting edge of precision medicine.
How Are Robotics and Genomics Converging in Surgery?
"Robotic surgery has already transformed what's surgically possible," Dr. Abirami explains. "The precision, the minimally invasive approach, the reduced recovery times — these are well-established benefits. But the next frontier is integrating genomic information into surgical decision-making."
She gives the example of cancer surgery. "When I'm operating on a tumor, knowing its genomic profile changes everything. Which margins are truly safe? Is this tumor likely to have spread microscopically? Which lymph nodes are at highest risk? Genomic profiling of the tumor — done before or during surgery — can guide these decisions in real time."
What Role Does Genetics Play in Surgical Outcomes?
"Genetics influences surgical outcomes in ways we're only beginning to understand," Dr. Abirami says. "Variants in genes affecting wound healing, inflammation response, and anesthesia metabolism all affect how patients recover from surgery."
She highlights pharmacogenomics as particularly relevant. "Anesthetic agents, pain medications, and antibiotics used perioperatively are all affected by pharmacogenomic variants. A patient who is a CYP2D6 ultrarapid metabolizer may need higher doses of codeine for pain control — but is also at risk of morphine toxicity. Knowing this before surgery allows us to plan the anesthetic and analgesic protocol accordingly."
How Is Robotic Surgery Changing Cancer Treatment?
"Robotic surgery is enabling procedures that simply weren't possible with open or laparoscopic approaches," Dr. Abirami explains. "For prostate cancer, robotic prostatectomy has dramatically improved functional outcomes — preserving continence and sexual function while achieving excellent oncological results. For gynecological cancers, robotic surgery allows precise lymph node dissection with minimal blood loss."
She sees the future in combining robotic precision with genomic guidance. "Imagine a robotic system that can identify tumor margins in real time using fluorescent markers targeted to specific genomic mutations. Or a system that can perform intraoperative genomic profiling to guide the extent of resection. These technologies are not science fiction — they're in development now."
What Advice Do You Have for Patients Facing Surgery?
"Ask about genomic testing," Dr. Abirami advises. "For cancer surgery, tumor genomic profiling should be standard — it guides not just surgery but adjuvant treatment decisions. For elective surgery, pharmacogenomic testing can optimize your perioperative medication management. And for any surgery with significant risk, understanding your genetic healing and inflammation profile can help your surgical team plan your care."
She also emphasizes the importance of genetic counselling for cancer patients. "A cancer diagnosis often reveals information relevant to the whole family. BRCA mutations, Lynch syndrome, hereditary diffuse gastric cancer — these have implications for siblings, children, and parents. A genetic counsellor helps navigate these family implications."
Know Your Genetic Cancer and Medication Profile
Genomepatri and MedicaMap by MapmyGenome provide genetic insights into cancer risk and pharmacogenomics — helping you and your surgical team make more informed decisions about prevention, treatment, and perioperative care.
