Saturday, July 13, 2024

Medical Robots Making Way for Improved Operations

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Sushruta has been dubbed as the father of surgery for writing one of the most detailed and ancient account of surgical processes. The sushruta samhita, works as a guideline for ayurvedic medicine worldwide and is still considered in high regard. However, today we have a medical robot performing the most complex of operations on a daily basis. I could only imagine surgery saying, “Father would have definitely been intrigued.”

Introducing the metal assistant

Involving machines in an operation raises the question of trust and reliability on the machine. However humans have been clever, they started with hands, moved to metal tools, then sterilised those tools. Now we are planning on controlling tools via a machine to add further precision. A medical robot allows for smaller incisions, better control of the instruments with a significant low risk of complication. Ideally it should be a welcome change. However, there’s a reason I said ideally.

Risks involved with medical robot

We all remember the iconic scene from star wars, where robots work on an injured Anakin Skywalker, and restore him to the infamous darth vader suit. However, a question that the clip raised was, why did none of those robots anaesthetise Anakin? This humanitarian touch missing from the robots makes a big difference. Human intervention could have made it an entirely different scenario.

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An estimated 6 lakh procedures were performed using a medical robot in 2015. Popularly known as Da Vinci Surgical system, it is growing at an estimated rate of about 10% each year. The indian market is not far behind. The trend is expected to catch up with about 100 hospitals across 25 cities adopting medical robots by 2020.

It’s internationally disastrous

According to online available stats, as of 2014, the robots had killed 144 patients, hurt 1,391 and malfunctioned 8,061 times in the US alone. A study by the British Journal of Surgery, concluded Human Development Index (HDI) was a major factor in the mortality rate for surgeries. “Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors.”

Additionally, a worrying matter is of collection of data in low-HDI countries. Surgical death rates are routinely collected in high income countries, such as the United Kingdom and United States, but there is little to no surveillance in as many as 70% of low and middle income countries.

Increased price point

The cost associated with robotic surgeries is another issue to be considered. A robot assisted surgery costs about $3,000 to $6,000 more than traditional laparoscopic surgery. Da Vinci surgeries additionally took longer time to perform and added an average of $2,000 to the said procedure. After all, it did take about 2 million to get one.

It’s not all bad

Risks involved with a medical robot will always be there but so will be the ones with humans performing surgeries. The involvement of robots has been advantageous in some ways as well. Chris Nebel, DO, FACS, member of Owensboro Health, specialising in general surgery, explained in the Owensboro Messenger-Inquirer, “The principle behind minimally invasive surgery is simple: Cut less, heal more.”

Minimally invasive surgeries are now being made much better. Sophisticated instruments and specialized techniques help in minimising the risk during surgery. Since the incision is smaller using these methods, patients bleed and hurt less resulting in a shorter and easier recovery process. Recovery times have reduced to days instead of weeks.

Considering the Indian scenario

After disrupting the rest of the world, cancer is making its way to India as well. Incidences of tongue and mouth cancers are on the rise, calling for head and neck surgery. Cancer at the base of the tongue can be efficiently taken up with the help of a medical robot. Resulting in least pain and minimal scarring to the patient.

Adoption of Robotic Surgery by government hospitals will ensure treatment to people who can’t afford private healthcare but deserve the latest medical attention. The government hospitals typically adopt a dual pricing system–charge only those who can afford.

Some statistics for India

According to the National Institute of Cancer Prevention and Research (NICPR), statistics for India are nothing short of alarming.

  • Estimated number of people living with cancer: around 2.5 million
  • Every year, new cancer patients registered: Over 700 thousand
  • Cancer-related deaths: 5,56,400

71% of all cancer related deaths are in the 30-69 age group

  • Total: 3,95,400
  • Men: 2,00,100
  • Women: 1,95,300

Aren’t these number something to look at? If cancer operations can improved with robots, shouldn’t there be more focus towards the solution?

Tracing the advances

Some plans indicate, increasing the current number of 190 robotic surgeons to about 500 by 2020 to cover 100 hospitals over the current 30. Raj Vattikuti, founder Vattikuti foundation explained the need for robotic surgery by offering 100 paid fellowships to super specialist surgeons, over the next 5 years.

“Even though 4,000 robot-assisted surgeries were performed in 2015, representing a fivefold increase in 5 years, India has not even scratched its potential, as the benefit can be passed to the masses beyond metro locations,” said Vattikuti at a press event last month.

Recounting benefits at a glance

Robotic surgery feels like an optimistic direction. It minimizes blood loss, reduces postoperative recovery time while bringing precision in executing surgeries. Medical Robot additionally brings in the best of science, engineering and medicine. These can reach organs and areas human fingers can’t. The magnifiable 3-dimensional view, helps the surgeons achieve precision, thus preventing collateral damage to healthy tissue.

Since the patient is back home on third day, the hospital can increase the efficiency of operations. instead of say ten days’ recovery period of conventional surgery, a daily wage earner can get back to productive work much earlier, while there is little to no pain, as robotic arms enter the body via tiny incisions. Healing is quicker for the patient and scarring minimal, after all, looks matter.


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