Express Healthcare

Digital Surgery-The future has already arrived

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Mukul Tripathi, Principal – Offerings & Solutions, Life Science and Healthcare Sales, Persistent Systems and Parimal Muli, Principal – Offerings & Solutions, Life Science and Healthcare Sales, Persistent Systems highlights that data insights will better assist surgeons in clinical decision-making and reduce cognitive fatigue.

Medical science has advanced by leaps and bounds over the last few decades. These developments have had a profound effect on surgeries as well. From traditional open surgeries using fixtures to use of robotic arms and advanced tools, we have come a long way to adopt new technologies. The next milestone in this journey seems to be digital surgery. It’s defined as convergence of surgical technology, real-time data and intelligence. Advancements in machine learning (ML) and artificial intelligence (AI) are enabling the creation of digital surgical solutions that connect the patient journey before, during, and after a procedure.

Let’s deep dive to understand how digital surgery is making inroads in the Indian healthcare scene and how technology innovations are driving faster diagnosis and minimal invasive surgery.

Growing needs

Existing healthcare infrastructure, especially in rural areas, is inadequate to meet the ever-growing healthcare needs of the population leading to surging healthcare demand. While on the supply side, most of the specialists are highly concentrated in urban areas. Overall, the abysmal doctor- patient ratio is 1:1,511 (against the WHO norm of 1:1,000) and national level, stock density of doctor and nurses/midwives is 8.8 and 17.7, respectively, per 10,000 persons.[1] These factors exacerbate the staff shortage and burnout issue, further increasing the demand supply gap.

Emergence of India as a medical tourism hub is leading to the growing need for state-of-the-art equipment. Also, the cost of Robotic surgery in India is significantly cheaper as compared to the developed nations. The cost of Single Robotic Surgery in India on an average is USD 2,000 to USD 15,800, whereas the same surgery in the US costs around USD 2,00,000[2]. Higher accuracy and faster recovery are leading to an increasing no. of people opting for robotic-assisted orthopedic surgeries.

Adoption challenges

Despite the strong growth in Indian digital surgery market, industry is plagued by low penetration. Some of its reasons are: Higher costs driven by purchase of the robotic system, maintenance and the disposable instruments required for each procedure, training, technical support, and insurance. Also, insufficient evidence of the effectiveness is responsible for low confidence on its adoption. Though research has established certain benefits of using robots, studies are still inconclusive about the effectiveness of robotic surgery in terms of techniques compared to conventional surgery.

Another bottleneck is lack of awareness. While there is growing awareness towards latest health treatments in cities, majority of India’s population remains ignorant about them. Other limiting factors such as most robots not being able to synchronize with existing hospital systems, are also limiting the impact of data in improving patient outcomes.

The road ahead

True potential of robotic surgery will be realised by digital surgery. Robotic surgery started in India in 2006, since then, its adoption by surgeons has become more widespread. There are about 70 centers for robotic surgery with around 80 robots and more than 500 trained robotic surgeons in India.[3] Indian medical ecosystem is on the path of transitioning into a digital surgical ecosystem in the coming decade. This will consist of a digital platform enabling imaging, analytics, and interoperability technologies to enhance the capabilities of robotic surgery thereby providing better precision and control, remote surgery, and enhanced doctor and patient experience.

In the near term, we’ll experience development of innovative point solutions across therapeutic areas, the patient’s journey, and the technology landscape. This will gradually mature to end-to-end broad platform offerings. Key technologies enabling this transition will be data insights based on AI/ML, Interoperability and Extended Reality (XR).

Data insights will better assist surgeons in clinical decision-making and reduce cognitive fatigue. Machine vision capabilities can also contribute to reduce surgery variance and improving outcomes. Pre-operative planning, intra-operative guidance, and computer vision can be some areas of application. Data interoperability will enable surgeons to obtain a complete picture of a patient’s health – including prior treatments and images regardless of the department in which that patient previously received care.

Further, to enhance surgeons and patients experience, extended reality (XR) will be used for surgical planning, training and education. For eg- TrueVision has developed a Digital Microscope Platform, which converts existing microscopes into digital surgery systems that can produce AR and 3D images.

Rapid developments in the field of robotics, artificial intelligence, genomics, and other digital technologies will make the healthcare practice less invasive and more personalised. Remote monitoring and connected ecosystem will become a reality with connected implants and IoT.

 

References:

[1] https://www.pib.gov.in/PressReleasePage.aspx?PRID=1758000

[2] https://www.practo.com/health-wiki/robotic-surgery-india/310/article#:~:text=The%20cost%20of%20Robotic%20Surgery%20in%20India%20is%20cheaper%20as,costs%20around%20USD%202%2C00%2C000.

[3]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6961426/#:~:text=The%20following%20decade%20saw%20an,assistance%20in%20these%2012%20years.

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