Robotic surgery cutting cost divide in Africa

May 12, 2015

Robotic surgery which is the use of sophisticated robots in assisting surgeons to perform very intricate surgery is now a reality in Africa, World’s poorest region. According to history, robotic surgery was developed in the late 90s to tackel the limitations of the popular key-hole surgery that is widely used for many surgical operations like removal of the appendix, gallbladder and for colon cancer. Since then, Robotic surgery has been for used for heart bypass, prostate removal, stomach cancer, colorectal cancer, thyroid nodules among others.The process involves a small fiber-optic camera which is inserted near the umbilicus. Under normal circumstances, surgery is performed with the help of two or three small instruments inserted through small holes in the abdomen. Key-hole surgery is immensely popular as patients experience less pain after surgery and faster recovery. However, there are some limitations of this key-hole surgery that makes it more difficult and less accurate in some types of surgical procedure as one of my nephew experienced in 2013. Robotic surgery has many unique and advanced features that overcome the problems of traditional key-hole surgery.Robotic surgery is now mature enough to deal with private business in public hospitals across Africa and as the procedure grew in popularity and more robots are being purchased, there were claims that growth was driven by smart marketing, not smart science.

While such claims have been largely dispelled, it remains true that the learning curve for surgeons using the robot is very steep. In a robotic surgery project am involved in, the surgeon are still very much in full control of the operation. Instead of surgeons using hands or key-hole instruments, they uses several very small robotic hands to perform the surgery. Robot arms are very flexible and function almost like human hands. Moreover, the robotic hand does not have any physiological tremor of the human hands. With the use of these very small, flexible and steady robotic hands,I have witnessed surgeon perform delicate surgery with unparalleled precision. In another case am familiar with in Zambia, a robotic system there offers a 3-dimensional vision for the surgeon that is not available in traditional key-hole surgery. Together with the higher magnification and high definition visual effect of the robotic camera system, identification and preservation of the small but important nerves and blood vessels have been achieved with ease during complex surgeries.Robotic-assisted minimally invasive surgery signifies a remarkable technological progress for a wide range of procedures traditionally requiring open surgery.With very good visualization and high accuracy, surgery is performed with minimal complications using the robotic system.The use of robotics has rapidly penetrated many procedures in surgery over the past five years in Africa.

Robotic surgery has been used for heart bypass, prostate removal, stomach cancer, colorectal cancer, thyroid nodules to mention but a few. In prostate surgery, the use of robotics is now widely accepted and recognized as a standard of care. The Da Vinci Robotic system has been approved for use in gastrointestinal surgery for the last fifteen years. South Africa was one of the first several countries in Africa to acquire a surgical robot. And since then, the robotic system has been successfully applied in many procedures benefiting many South Africans and foreigners as well.South Africa is currently the leading center for robotic surgery in Africa and has also provided training for many surgeons from in and out of the country who are keen to acquire the skill of robotic assisted surgery. Research has shown that Robotic surgery offers all the benefits of traditional key-hole colorectal surgery to patients, like faster recovery, shorter hospital stay, fewer complications, lesser wound infection and smaller scars. With the greatly improved visualization, precision, control and dexterity provided by the robotic system in the narrow pelvis, injuries to the tiny nerves that control the bladder, bowel and sexual organs can be avoided.With medical technology evolving at an extraordinary pace, surgical robots in Africa are making inroads into the operating room.By allowing surgeons to perform complex operations through small incisions, it diminishes the level of patient ordeal and helps considerably improve patient outcomes and African countries stands to benefit most bearing in mind the small number of surgeons.

Contador Harrison