Despite decades of effective robotic-assisted surgeries globally that have positively impacted millions of patients, the access is scarce at big. The dominant existing robotic program is highly-priced and linked with a steep finding out curve, resulting in the restricted availability across the world of more than six billion persons. In an exclusive conversation with TheSpuzz Online Dr. Sudhir P. Srivastava, Founder, Chairman & CEO, SS Innovations mentioned that robotics shall be the future of surgery, and he aims to make a technologically sophisticated program that will be expense-powerful, quick to use, and can be applied to all surgical specialties. Thus, benefitting most patients about the world. Compared to standard surgery, robotic surgery outcomes in smaller sized incisions, that reduces discomfort, scarring and leads to faster recovery, he added. Excerpts:
What is the existing state of the newest innovation and technologies in healthcare and healthcare, please elaborate.
Over the last 70 years, medicine has sophisticated substantially due to the fact of new discoveries, developments and newer technologies from a plain X-Ray to CT Scans, MRIs, ECHOs and 3D imaging to give more information about the illness procedure. Various Artificial Intelligence and algorithms can decide pretty promptly in relation to differential diagnoses. There are machines that can give speedy interpretations in remote places exactly where there are no physicians present, for instance to produce an EKG report with interpretation using AI and machine finding out. The utilization of technologies in the field of medicine has often been vital with the objective of advancing science. A fantastic instance of this is the comparison among minimally invasive surgery and standard open surgical approaches. The standard approaches carried with them an enhanced threat of infection, slower recovery occasions and post-operative discomfort which eventually impacted the high-quality of life of the patient.
There was an evolution of surgery from these open approaches to laparoscopic, or keyhole, surgery and today robotic assisted surgery. Additionally, many remedy methodologies have changed, as an alternative of excision, now ablation of cancers inside the body is carried out to stop systemic side effects of many remedies. Nanotechnology is now becoming applied in relation to drug delivery in targeted therapy for many systemic illnesses. Stem cell analysis is ongoing with regards to the regeneration of organs and 3D printing is now becoming applied for modelling of organs to superior have an understanding of the illness processes. Lastly, telemedicine has come to the forefront with astonishing advancements exactly where healthcare diagnosis and care can be carried out remotely and telesurgery, exactly where surgery can be carried out remotely using technological advancements in connection speeds and bandwidth.
How far has healthcare robotic surgery come from its origin?
In the 1980s the United States Defense Department and NASA funded analysis to create technologies to be capable to treat patients in space and the battlefield, nevertheless, at that time the technologies was not mature and bandwidth was not out there for telesurgery. Early robotic corporations came into existence in 1988 with the PROBOT which was created at the Imperial College of London to carry out prostate surgery, then ROBODOC from Integrated Surgical Systems in 1992 to mill out precise fittings in the femur for hip replacement. IN 1998 a Trans-Atlantic surgery was carried out with the Zeus program, nevertheless, there was substantial latency and the expense was prohibitive but it did show that a telesurgery Proof of Concept could be accomplished. Robotic surgery began at the patient level in 1998 and more than the last 20 plus years, more than 7 million robotic operations have been performed globally. Even even though so numerous procedures have been carried out, when analysing the numbers, an even international penetration has never ever been reached due mainly to the higher capital expense of the robotic program. Today there are more than 5700 robotic systems in the world, 93% are among the United States, Europe, and Japan. This implies virtually 6 billion persons in the world do not have quick access to this sophisticated healthcare technologies, mainly due to the expense. If you do not have access to the program then you can not train and turn out to be superior at your approaches.
Even in components of the created world, the availability of robotic surgery choices stay in bigger cities which implies that in smaller sized cities a patient will have to travel in order to get superior surgical choices. Over 140 corporations and analysis institutions are presently working on many robotic systems for a big spectrum of applications. There are more than 20 robotic systems that have been launched but there are only a couple of that are becoming applied in a clinical setting. In the next 3-4 years there will be an more 10-15 corporations emerging with respect to specialty particular technologies.
Tell us about the launch of MANTRA
Despite decades of effective robotic-assisted surgeries globally that have positively impacted millions of patients, access is scarce at big. The dominant existing robotic program is highly-priced and linked with a steep finding out curve, resulting in the restricted availability across the world. Taking this up as a challenge and major with a vision to offer you minimally invasive robotic surgery options, we have launched the MANTRA surgical robotic program. It is a expense – powerful, modular surgical robotic program created to carry out minimal access surgery with high precision, manage & dexterity. It can be utilized for all important surgical specialties such as Urology, General Surgery, Gynaecology, Thoracic, Cardiac, and Head & Neck Surgery.
How significantly time did you take to take from inception to receiving the solution prepared?
I came to India as founder and chairman of the International Centre for Robotic Surgery to be capable to launch applications in the nation. After possessing come to India in 2011 and launching applications, I realized that the expense was a important inhibiting element for our patients to undergo surgery. The capital expense was higher and the per process expense was also highly-priced. In 2012, I decided to invest my time and cash to come up with a program that would be expense-powerful. Initially, my mission took me to Germany, and then in 2013, I place collectively a group of engineers to commence hunting into building some of the suggestions that had been pretty various for a technologically various robotic systems that would also be expense-powerful and have more capabilities.
It has taken us about 4 years or so, to come up with the newest generation of the MANTRA surgical robotic program. Recently, in our initial in human clinical pilot study using the MANTRA surgical robotic program, we effectively completed 18 complicated abdominopelvic procedures at the Rajiv Gandhi Cancer Institute, the premier hospital for Oncology Surgery in India.
Tell us about your group, who worked on this project?
What it took truly for this good results in a fairly quick time and with restricted economic sources was the association of a clinical encounter with a pretty talented group of young engineers. The majority of this group is from India, even though we do have international engineers along the way who have helped us. These are renowned professionals in the field of robotic engineering. The SSI group has been aided by world renowned robotic surgeons and extremely knowledgeable consultants from about the world. The committed and focused efforts have resulted in an cost-effective multi-arm SSI Mantra Surgical Robotic System that would advantage numerous more patients about the world to decentralise access and excellence.
What are your plans for expansion and additional improvement?
Our vision is to create an cost-effective program that can turn out to be out there to the masses. Our objective is to be capable to sell to the finish-user in India at someplace among 4 to 5 crores. This will additional retain the expense of procedures as effectively as the upkeep contract pretty cost-effective. The hospitals can afford it and in return, more and more patients will advantage from it. Our plans for the future incorporate generating the program commercially out there later in 2021 and establishing our manufacturing and assembly inside India. We have raised more than 300 crores or so from many sources but at this point. We will be launching our next round of funding for which our objective is to raise someplace among 700 to 1000 crore to establish the infrastructure assistance systems, manufacturing and to location ourselves as a international robotic surgery organization. My dream and vision are truly to make the robotic program out there in components of the world exactly where patients would otherwise not have access. Additionally, we would hope that our program could be placed across Indian Medical Colleges so that, just as surgeons come out of their PG courses as educated laparoscopic surgeons, they could also have the chance to train as robotic surgeons as effectively.
What differentiates MANTRA from the current Robotic program in the marketplace?
MANTRA is exclusive in its strategies that it is modular with an open face console. This design and style delivers superior ergonomics for the surgeon even though providing complete view of hand controls, foot pedals and surgical group. The surgeon can view the complete operating area for active guidance. Modular Robotic Arms with several adjustments are mounted on person motorised carts for quick movement, positioning and docking. The design and style makes it possible for for total flexibility as to quantity of arms for particular procedures (3-5 Arms), positioning based on target anatomy and body habitus. The numbers of arms applied are customisable based on kinds of procedures, finish user needs and budgets.
Our program will be beneficial in all surgical specialties, except orthopaedic at this point. Additionally, we will be such as cardiac surgery as one of our focuses. Currently, no other organization in the world is focused on all elements of cardiac surgery, particularly robotic cardiac bypass procedures. The rewards in cardiac surgery are so enormous in terms of possessing the complete complicated operation carried out by way of tiny holes versus possessing the sternum split open, which is linked with a lot of trauma, surgical complications, and pretty extended recovery periods.
Another important element that we thought of in this improvement was the expense. The existing dominant program in India at the highest level sells for among 16 to 18 crores. As talked about, our vision is to create a program that can advantage the masses and numerous more hospitals, as such, our program will be out there at on-third of that expense.
As a element of Make in India, what is the assistance you are in search of from the government?
As a element of the Make in India initiative, we would like for the government to extend a assisting hand towards the robotic surgery segment by lowering the import duty on vital electronic elements and other elements that are not indigenously produced in India. Government assistance is also essential to improve the penetration of robotic surgery technologies to the tier 2 and tier 3 cities to guarantee that it must be quickly out there to patients across the nation at an cost-effective and subsidized price. Create partnerships to be capable to expand healthcare to remote places. Robotic surgery coverage below Ayushman Bharat for half a billion persons.
For robotic surgery to enter the mainstream healthcare infrastructure, the government must introduce robotic surgery at educational institutions. This will support the new generation to associate with this revolutionary technologies. If fellowships are provided in robotic surgery, and post-graduate courses are began in this field, then a pool of effectively-educated robotic surgeons and world-class infrastructure can be created inside the nation. India actually has an chance to turn out to be world leaders in robotic surgery, with our big population base and want to advance amongst the healthcare neighborhood, a enormous database based on the cumulative clinical encounter that can be used to advance additional analysis and improvement and teaching and coaching. With regards to improvements in infrastructure, telesurgery can be accomplished but it would need higher speed bandwidth across the nation in order to facilitate this novel application.
The following measures would additional support to guarantee penetration of robotic technologies in the nation:
1. Supporting the establishment of robotic surgery applications in public hospitals and placing policies in location that facilitate the adoption and access to the technologies
2. Providing the essential infrastructure to localize the production of surgical robots.
3. Giving preference to Indian items more than foreign-made items if the high-quality requirements are the identical.
4. Promoting indigenous manufacturing of many electronic elements, motors, and drives, and so on.
Could you throw some light on the challenges and roadblocks you faced for the duration of this project?
Apart from the pandemic due to which the project was delayed by virtually an year, the greatest hurdle that slowed us down is the dependency on foreign manufactures for importing sophisticated gear. We are hoping that the government will take essential measures to provide vital facilities to indigenous robotic surgery commence-ups.
Apart from the above, we becoming a commence -up faced the identical set of challenges as just about every commence up such as procurement of funds and talent, meeting the investment milestones, manufacturing delays and so on., which we overcame with time, work and consistency.