Journal of Minimal Access Surgery

EDITORIAL
[Download PDF]
Year : 2015  |  Volume : 11  |  Issue : 1  |  Page : 1-

Is the Indian surgical arena ready for the robotic platform?

Arvind P Ganpule 
 Department of Urology, Muljibhai Patel Urological Hospital, Nadiad - 387 001, Gujarat, India

Correspondence Address:
Arvind P Ganpule
Department of Urology, Muljibhai Patel Urological Hospital, Nadiad - 387 001, Gujarat
India




How to cite this article:
Ganpule AP. Is the Indian surgical arena ready for the robotic platform?.J Min Access Surg 2015;11:1-1


How to cite this URL:
Ganpule AP. Is the Indian surgical arena ready for the robotic platform?. J Min Access Surg [serial online] 2015 [cited 2022 Sep 27 ];11:1-1
Available from: https://www.journalofmas.com/text.asp?2015/11/1/1/147648


Full Text

As surgeons, we need to understand the indications of "robot" as a new tool in the Indian context. It is quite evident that the surgical robotic platform is a tool, and it cannot replace good surgical technique. It is over a decade since the robot was approved for use by the United States (US) Food and Drug Administration. The indications and application for robotic surgery are ever expanding since then.

In India, we are at crossroads. Installations of robots have increased fourfold in the past 5 years. Jain and Gautam in their article in the current issue have put forth a very interesting fact. [1] They note that in the year 2012 and 2013 the number of installations that have been commissioned in India increased by over 40% as against the global average of 21%. This may indicate the fact that probably we have too fewer installations than we need. Secondly, the authors note that the indications for robotic surgery differ in the west as compared to India. Gynaecologist is the most frequent users of the robot as compared to Urologist elsewhere in the world. In India, the most frequent user of the robotic platform is the Urologist. Does it mean the other specialties are underutilising this technology or does it mean the medical fraternity as such is not convinced about it?

Given this background, the aim of this issue is to bring out evidence-based facts from robotic surgeons in India. We have focused on application of robot as a tool for various specialties and subspecialties. The issue intends to bring out the indications, pros and cons of use of robot in the respective fields. The authors of each invited review article have focused on the contemporary literature. Sood and Bhandari have touched on an important and interesting topic of robotic training. [2] A healthy academically oriented debate is the crux of a good scientific society. Two giants in the field have debated if we in India are ready for the robotic platform. [3],[4] We have tried to make the issue all-encompassing by including a wide spectrum of experts in the field ranging from gynaecology, thoracic surgery, paediatric surgery and uro-gynaecology. In addition, we have also included few original articles, case reports and personal viewpoints pertinent to robotic surgery.

A new invention or development is first greeted with disbelief, followed by criticism and finally acceptance. The same holds true for the robotic platform. The "well-known" critique of robotic surgery is the cost. The increasing cost of healthcare has been a matter of concern in the US as well as elsewhere around the globe. This has led to questions being posed about the utility of the robot, particularly in a cost conscious society such as India. The second critique is the lack of evidence-based data for procedures performed robotically in comparison to laparoscopy or open approach. Both these critique was evident during the early developmental days of endourology as well. The "value" of any new addition to the surgical armamentarium should be recognised before setting it up on a pedestal or relegating it to the dustbin. The same holds true for robotics as a new technology. The jury is still out! As Alexander Pope, the famous English poet once said "Be not the first by whom the new is tried, nor yet the last to lay the old aside."

References

1Jain S, Gautam G. Robotics in urologic oncology. J Minim Access Surg 2015;12:40-44.
2Sood A, Bhandari M. Robotic surgical skill acquisition: What one needs to know. J Minim Access Surg 2015;12:10-15.
3Desai M, Chabra J, Ganpule AP. Robotic surgery is ready for prime time in India: For the motion. J Minim Access Surg 2015;12:2-4.
4Udwadia TE. Robotic surgery is ready for prime time in India: Against the motion. J Minim Access Surg 2015;12:5-9.