Dr Miten Sheth, Orthopaedic Knee Surgeon & Director, The Knee Clinic highlights the role of technology in orthopaedics
Technology has changed healthcare in two tangible ways, increased accessibility to treatment and ensuring consistently reliable outcomes. As far as knee replacements are concerned, robotics assistance during surgery can potentially lead to faster recoveries, a more natural feel to replaced knees and improved longevity.
So where does India stand, compared to developed countries, in terms of usage of robotics in the healthcare sector? According to Philip’s Future Health Index 2019 report, 76% of healthcare professionals in the country are already using digital health records. India also meets the 15-country average (46%) related to usage of artificial intelligence in healthcare. Over the years, robotics-assisted surgeries have made significant contributions to Indian healthcare industry, with the growth of the Indian robotic-assisted surgical market expected to reach ₹2,600 crore by 2024 at a CAGR of 19.8%, as per market reports. Senior analysts predict that almost 50% of all surgeries in India will be robot assisted by 2025.
India’s healthcare is mired in multiple challenges, from efficiency to the need for proper infrastructure. In addition to shortage of healthcare professionals, rural regions face a lot of barriers in terms of accessibility. Most of these hurdles can be neutralised through a shift of the healthcare system towards collaborative and preventive healthcare. Robots and artificial intelligence can potentially be the solution. Although robotic technology is currently expensive for wider adoption across healthcare settings, its adaptability with reference to robotic assistance in surgery has already made in-roads. Reports suggest that there are over 500 robotic surgeons in India, including deployment at government and private healthcare facilities. Remote surgery can enable Indians to save travelling and boarding costs over and above the usual hospitalisation costs. In addition to assisting surgeons, robots have been playing a critical role in training young medical professionals to become future surgeons. It has accelerated the process of producing more skilled young surgeons by reducing time and enhancing effectiveness.
Robotics-assisted Replacement surgery is an advancement in the way orthopaedic surgeons perform Knee Replacements. Robotic assistance is provided by an advanced computer program (on a console) that relays precise, real-time information to a surgeon-held device. Every procedure has an individualized plan based on each patent’s unique anatomy. The surgeon first maps the unique shape of the arthritic knee with a special pencil tool. A 3D mock-up of the native knee is then generated, on which the computer tries to custom fit and size implants (replacement components). Once this plan is approved by the surgeon, the resurfacing is executed with a special robotics-assisted handpiece that works within pre-defined boundaries, minimizing tissue damage and eliminating human errors. Greater accuracy and precision leads to lesser tissue damage. Consistent and repeatable technique leads to lesser errors. Individualised surgical plans ensure natural feeling knees.
Shorter patient recovery times can ensure faster ‘admission to discharge’ times, hence freeing up hospital beds and reducing overall hospitalisation expenses.
The Indian Government is at the forefront of this revolution. The Ayushman Bharat Digital Mission (ABDM) aims to develop the backbone necessary to support the integrated digital health infrastructure of the country. It will bridge the existing gap amongst different stakeholders of healthcare ecosystem through digital highways. In coming times, the Government must focus on strengthening clinical infrastructure and push for quicker assimilation/integration of technology at various levels. Robots are meant to be the center of real intelligence in operating rooms. Semi-autonomous and autonomous robots conducting procedures and predictable, consistent and efficient surgeries are slated to be the norm.