Robotic Surgery and Science: The Director of Botkin Hospital on the Past, Present, and Future of the Legendary Clinic

Translation. Region: Russian Federation –

Source: Moscow Government – Moscow Government –

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Advanced technologies, innovative treatment methods, outstanding doctors and scientific discoveries – Moscow Multidisciplinary Scientific and Clinical Center named after S.P. Botkin Since its founding, it remains one of the largest and most innovative hospitals not only in our country but also abroad. In December, it celebrated its 115th anniversary. A mos.ru correspondent spoke with its director, Moscow's chief freelance surgeon and endoscopist Alexey Shabunin, about the past, present, and future of this legendary clinic.

Luminaries of Medicine and Their Successors

— Alexey Vasilyevich, the Botkin Center is now one of the oldest and largest hospitals in Moscow. How did it begin?

It owes its existence to the philanthropist and merchant Kozma Soldatenkov. He bequeathed nearly two million rubles for the construction of a medical facility for everyone, regardless of rank, class, or religion. Soldatenkov Hospital opened on December 23, 1910, and even then it was the largest in Europe, boasting state-of-the-art equipment. After the advent of Soviet power, it was renamed in honor of Sergei Botkin, the founder of the physiological approach to clinical medicine. Over the years, it remained at the forefront. During the Great Patriotic War, the hospital repatriated soldiers and established a blood transfusion station, thanks to which the front received over 92,000 liters of blood and blood components.

Botkin Hospital has always brought together talented doctors and scientists. Surgeon Vladimir Rozanov operated on Vladimir Lenin and Joseph Stalin. He is also the inspiration for Professor Preobrazhensky, the hero of the novel "Heart of a Dog": the doctor was friends with Mikhail Bulgakov, and based on their conversations, the writer created the character of the experimental surgeon. Pathophysiologist Vladimir Negovskiy opened the first intensive care unit in the USSR in 1959 (then called the Center for the Treatment of Shock and Terminal Conditions). We also employed the founder of Russian clinical pharmacology, Boris Votchal, and the renowned therapist Miron Vovsi. In the 1960s, Gert Kulakov launched the Soviet AIP-60 machine, known as the artificial kidney. This marked the beginning of hemodialysis services in the USSR and transformed the treatment of people with acute renal failure.

— What principles of work were formed by outstanding predecessors?

They laid the foundation—a multidisciplinary approach. Notice the hospital logo: the shield symbolizes the protection of health. Inside are four smaller shields, facing each other—representing different medical specialties coming together. Doctors from several specialties collaborate closely, becoming a unified whole. A striking example is the transplant department, which opened in 2018. Organ transplantation is a feat not only of surgeons but also of internists, intensive care specialists, geneticists, cardiologists, nephrologists, gastroenterologists, and hematologists.

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Flagship, vascular, simulation and other centers

— About 10 years ago, a major renovation of the hospital began. How did this impact the quality of care?

We renovated and built 16 medical buildings—essentially, not one, but three hospitals. Moreover, we connected the historic buildings with walkways, creating a seamless space within the complex.

The newly constructed building houses a high-tech emergency care center—our flagship. Even at the design stage, doctors and architects considered logistics. For example, at the entrance, patients are assigned to a "triage" system—red, yellow, and green zones based on treatment priority. Meanwhile, the ambulance crew informs us of the patient's symptoms while en route, via a digital platform. Before their arrival, we prepare equipment and a team. All this has reduced decision-making time, and in life-threatening situations, every minute counts.

— What other specialized centers operate at Botkin Hospital?

The Moscow City Hematology Center provides comprehensive services to people with blood diseases, including chemotherapy, immunotherapy, and targeted therapy, as well as bone marrow transplants. The Interdistrict Nephrology Center treats kidney pathologies. For the first time, all care in this area—from dialysis to transplantation—is concentrated in a single building.

Furthermore, the Botkin Center is one of the capital's anchor hospitals where patients with malignant tumors undergo diagnosis, treatment, and lifelong monitoring. At the outpatient oncology center, they are supervised by a single team of doctors.

In 2016, a regional vascular center opened. We demonstrate the best results in the country in the treatment of strokes and heart attacks. This is due to the hospital's state-of-the-art equipment and the fact that rehabilitation begins within the first hours after a patient's condition has stabilized. In 2019, Moscow's only city ophthalmology center opened—one of the largest and most modern eye clinics in Russia and Europe. It treats all pathologies, including cataracts, glaucoma, retinal dystrophy, and cancer. In 2021, the city's first high-volume endoscopic center for the early diagnosis of gastrointestinal oncology opened.

We share our experience and knowledge with medical professionals from other Moscow institutions. At the simulation center, they practice using robotic simulators that mimic human physiological functions.

Saving sight: How doctors at the Moscow City Ophthalmology Center of Botkin Hospital workSurgeries of any complexity and high technology: a tour of the flagship and urology centers of Botkin HospitalSobyanin spoke about the results of the implementation of a new standard of oncological care.

Robotic surgeons and organ transplantation

— What is a hospital operating room like?

We have over 70 operating rooms, including hybrid ones—those where a patient can be operated on simultaneously by doctors from several specialties, such as traumatologists, neurosurgeons, and cardiovascular surgeons. Our team has angiographs, C-arm X-ray machines, high-precision microscopes, neuronavigators, and other equipment at its disposal. Our center is also a recognized leader in robotic surgery.

— How are robots transforming surgical treatment?

We have six robotic systems in our arsenal. Take a look at the model in my office: it reproduces a scene from an operating room. I sit at the machine and program commands, and the robot operates according to my instructions. Together, we are stronger: I have the experience and knowledge, and the assistant's arms can rotate 540 degrees. Today, robotic surgery is the most minimally invasive and effective surgical treatment method. We perform over two thousand such procedures a year.

Most surgeries are performed using a different, minimally invasive technique called laparoscopy. It differs from open surgery in that we access organs through punctures rather than incisions. Instruments and a camera are inserted through these incisions. For vascular surgeries, we use an endovascular technique (also performed through punctures, but under X-ray guidance).

— Is organ transplantation one of the most difficult operations?

— Yes, many nuances need to be taken into account. While kidney and heart transplants primarily involve vascular interventions, liver transplants also involve work with the ducts and intestines. However, difficulties arise early in the process, when selecting a donor organ. Still, Moscow has minimal waiting times by international standards: kidneys are five to six months, livers one and a half to two months, and hearts are a month. After the surgery, we monitor how the organ is taking hold, whether there is any rejection, and how the immune system is responding. Despite the complexity of the procedure, we have performed over a thousand successful transplants since the department opened in 2018. About 160 kidney transplants, 100 liver transplants, and 20 heart transplants are performed annually.

Health Factory

In 2024, the hospital received the honorary status of Moscow Multidisciplinary Scientific and Clinical Center. What unique techniques are the doctors developing?

We've been innovators in medicine since the hospital's founding. Today, our scientists are practicing physicians. It's important that they make discoveries not just for the sake of discovery, but strive to analyze their clinical experience and improve the quality of care. Medicine and science are inseparable.

For example, we developed an endoscopic method for surgically treating peptic ulcers complicated by bleeding, as well as a unique technology for machine perfusion of organs during transplantation. Previously, we would remove organs from the donor, rinse them in a cold environment, and leave them there while the patient was being prepared for transplantation. Now, we enrich the organs with an oxygen-rich solution. This simulates blood flow. The organ continues to function, and it then engrafts more quickly in the recipient.

— What traditions have doctors maintained over the decades?

— Compassion and compassion for patients have always been cultivated at Botkin Hospital. They go hand in hand with professionalism.

— How does the historical clinic plan to develop in the future?

"Currently, the hospital provides care to over 140,000 patients in our 24-hour inpatient department and over two million in our day care department. It's a true health factory. We plan to expand our capabilities in the future, primarily by renovating our main building, Building 22. Furthermore, with our new status, we've increased our scientific potential and will be developing our research. All of this will ultimately allow us to achieve even greater success in the global healthcare system."

Sobyanin: Robotic surgery significantly expands surgeons' capabilitiesSergei Sobyanin explained how Moscow's transplant service operates.

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