Robotics in Public Health and Medical Science

Robotic surgery or robot-assisted surgery provides some relief for the cancer patients against the relentless cancer disease. The cancer patients look towards them for precision during radiation and chemotherapy. They also perform many intricate surgeries with precision.

The da Vinci surgical robot with brains equivalent to software packed in several PCs is the front-runner in conducting minimally invasive surgery. The following sections discuss about the features, advantages, criticisms and evolution of surgical robots.

Features

• The da Vinci surgical robot combines the best of science & technology and medicine.
• The robot is nothing but a 1000 kg of hardware. The brains of the robot are equivalent to software packed in several PCs. The robot includes 2,250-odd patents. Additionally some 1,550 more patents are pending.
• The robot has been created by US-based Intuitive Surgical Inc. In India, the use of these robots has been expanded to 47 hospitals in 20 Indian cities in the past six years.

Why robotic surgery is in demand?

With advancements in medical technology, new highs are reached in the domain of robot-assisted surgery. The demand for robotic surgery is pushed by the following factors:

• Rising healthcare expenditure;
• Advancements in technology;
• Rising incidence of chronic diseases;
• High incidence of medical errors;
• Demand for faster recovery and reduction in pain;
• Increase in awareness about the benefits of robot-assisted surgery.

Advantages

The surgical robots provide high resolution three-dimensional visuals and 10-fold magnification. It provides freedom of movement and its motion can be scaled up to suit the needs of the surgeon. Unlike surgeon’s hand which misses out the precision due to tremors, these robots with wristed instruments helps in improving precision to surgical procedures. The robots help the surgeons to operate with enhanced precision, dexterity and control during the most complex surgical procedures.

They give the surgeons magnified views of the damaged tissue in a high-definition 3D format. The flexible arms of the robot can enter the human body through tiny incisions and makes precise repairs to bring relief inside the body. It is hailed as a major breakthrough in minimally invasive surgery and a major step up from laparoscopic procedures. These robots help in removing cancerous tissue which is difficult to locate while retaining healthy tissue in cancer patients. The surgical instruments used by the robot are smaller, flexible and highly manoeuvrable when compared with the human hand.

It takes a lot of practice and perseverance for surgeons to excel in complex procedures like laparoscopic surgery. The use of the surgical robots has made that learning curve easy and makes sure the availability of the expertise in a shorter period of time.

Criticisms

The flip side of using the robots for surgery is its high cost of installation. These instruments are not only expensive but also incur a large recurring cost due to the disposable nature of instruments and ancillaries. There exist only a few companies that manufacture the equipments for robotics surgery. In addition, the monopoly of few companies makes it difficult to expand robotics surgery in the Indian healthcare system. Another challenge is the unavailability of trained surgeons for conducting robotic surgeries.

Way forward

The way forward is to establish fellowship programmes and offer structured training to surgical teams. With the increase in the number of robotic surgeries, there will be an acute need for training of doctors for carrying out such surgical processes. In India, training and certifying of surgeons remains a challenge.

Also, the high cost involved in treatment of cancer increases the overall financial burden on patients. So, the government should promote collaboration between hospitals and insurance companies to come up with innovative ways to tackle the high cost of robotic surgeries.

Background

Robotic surgery had its humble beginning two decades ago and at present significant improvements have been noticed in this technology. With the improvements in technology, robotic surgery has extended across multiple specialities like cardiac, general surgery, gynaecology, head & neck, vascular and paediatrics etc. In India, the robotic surgery has witnessed significant improvements in the past few years. In 2015 alone, around 4,000 robotic surgeries have been performed, which is a five-fold increase over 2011. The new technology has brought about a paradigm shift in the way a surgeon performs the surgery. The only limitation of the robotic surgeries is their prohibitive costs. Globally, the costs associated with cancer treatment are comparatively higher than the treatment costs for any other disease. Advanced R&D facilities will help in addressing the demand for cheap healthcare in the medical robots industry. In addition, the development of nano-robots is also expected to aid the growth of the medical robots market.

Medical robots are classified into non-invasive radio-surgery robots, surgical robots, rehabilitation robots, hospital and pharmacy robots etc. The surgical robots are those that reduce the complications involved in surgeries and improve the accuracy of the procedure. Surgical robots are further classified into orthopaedic surgical robots, laparoscopy robotic systems, steerable robotic systems, neurosurgical robotic systems etc. The neurosurgical robotic systems are expected to witness an increase in demand for minimally invasive surgeries and improve the accuracy of the procedure.

According to reports, North America followed by Europe has the largest market for robot assisted surgery. The global market for medical robots has witnessed an increase from $4.90 billion in 2016 to $12.8 billion in 2021 with an aggregate CAGR of 21.1%. Further, the developing nations like China, Japan and India are expected to experience the highest growth in robotic assisted surgery in the future. The growth of medical tourism is also expected to lead to the adoption of more and more surgical robots in metro cities. The robot-assisted surgery is expected to make inroads into tier-II and tier-III cities in India.