Compared to the western world, robotic surgeries in India are still at a nascent stage. India’s contribution to robotic surgeries in a year is less than 0.1 per cent, globally. The awareness about robotic surgery is still not at a mass level in India, and coupled with this, not many surgeons are trained for this procedure. Further, the high cost of a surgical robot is one of the major barrier to high penetration.
It was in 2012, when Dr Sudhir Srivastava, currently MD and Chairman of SSI Innovations, a medtech startup, met a 22-year-old lady who was diagnosed with a hole between the two chambers of her heart. She was recommended a surgery, but her brother thought that a large cut on the chest might be a barrier for her to get married. Hence, Dr Srivastava told them about robotic surgery which they could not afford.
“I even offered them my services for free, but the hospital I was working in at that time insisted on payment which could have run into several lakhs of rupees. Her brother said they will raise the necessary money and come back. A month later, he called to say that they were still struggling to raise the money, and, after that, I never heard from them. This incident set me to think that the common person should not be denied high-tech and high-quality medical care for want of money. I set into motion to develop a cost-effective surgical robot for the benefit of the masses.”
In 2021, Dr Srivastava came up with India’s first Made-in-India surgical robot called SSI Mantra. Till date, it has been deployed in Rajiv Gandhi Cancer Institute, New Delhi; Sanjeevani CBCC USA Cancer Hospital, Raipur; Continental Hospital, Hyderabad; Hindusthan Hospital, Coimbatore and Cytocure hospital, Mumbai.
“With SSI Mantra, the surgeries can be performed at just 1/3rd the cost of current robotic procedures. It was developed to make the system cost and surgeries more affordable so that more hospitals can buy it, and, in turn, people can also have access to high-quality medical care,” Dr Srivastava said.
India is lagging behind the US and European countries and instruments have limited number of usages, informs Dr Pradeep Jain, Principal Director and HOD, Gastrointestinal Oncology, Fortis Hospital.
“Some instruments for such surgeries cost Rs 3 to 4 lakh, but their usage is limited to just 10 procedures, and the cost also ranges from Rs 1 to Rs 1.5 lakh,” he said.
Most of the hospitals use DaVinci surgical system manufactured by Intuitive Surgical, costing about Rs 15-18 crore. It is a United States Food and Drug Administration (USFDA)-approved surgical robotic system.
Malfunctioning of the robot (although extremely low) is a potential risk, though.
“Robotic surgeries are also deployed for carrying out remote surgeries that are dependent on high speed and stable internet connectivity, the absence of which, can be a challenge. Hopefully, 5-G comes as a saving grace for seamless connectivity. Also, being relatively new and growing in leaps and bounds, governmental regulations will take some time to be put in place,” Dr Srivastava further said.
At present, SSI, is commencing dialogues with the USFDA, post which it will share a list of documents that maybe needed in addition to plan, organise and execute its clinical trials for the FDA approval. It hopes to get the approval next year for SSI Mantra.