BENGALURU: The da Vinci Xi, a robotic surgical system, is one of the latest additions to Kidwai Memorial Institute of Oncology’s hi-tech gadgetry, and the hospital has performed 53 procedures after acquiring it.
The equipment costs Rs 16.5 crore and the hospital is the only one in the state to have the advanced version. Private hospitals have older versions like the da Vinci Si surgical system.
The advantages of robotic surgery include patient comfort, smaller incisions, lesser risk for infection, surgical accuracy, better accessibility and faster recovery although the patient is kept under anaesthesia twice as long as it is in traditional procedures. However, for 18,000 new cancer patients that Kidwai sees annually and at least 2.5 to 3 lakh patients who come for the follow-up, the good news is, if they are being operated upon with this new equipment, it is not coming at an additional cost.
“It is the consumables and disposables that add to the procedure’s cost. In robotic surgery, each consumable costs at least `70,000. For the first two years, we are getting around 200 consumables for free and hence no cost is being levied on the patient. After two years, we will write to SAST (Suvarna Arogya Suraksha Trust that runs the state’s medical insurance schemes for the poor) to cover robotic surgery procedures and look for donations as well,” said Dr Krishnamurthy, head of surgery at Kidwai.
Also, da Vinci Xi would not require any expenditure on maintenance in the first two years but later it would cost Rs 80 lakh annually. This has to be borne by the institute just like how Rs 4.5 crore of the cost of da Vinci Xi was borne by it (Rs 12 crore was given by the Centre). The equipment can be used to operate rectal cancer, stomach cancer, perform hysterectomies, cancer of the oesophagus, abdomen and thorax.
“Head and neck cancer cannot be operated by this equipment yet. Currently, six surgeons at Kidwai are trained to operate with da Vinci Xi,” he said.
The equipment has a surgeon console, image processing equipment, endowrist instruments, surgical arm cart and hi-resolution 3-D endoscope.
A city-based onco-surgeon who did not want to be named, expressed his reservations about robotic surgery.
“The learning curve is great with robotics and indications are currently limited. Surgeons can be trained in a week. But, a conventional hysterectomy, which takes one-and-a-half hours, may take up to eight hours in robotic surgery in initial period with steep learning curve. Studies done so far does not prove the superiority of robotic procedure over conventional techniques for risk reduction or improved survival.
Specific studies on quality of life advantage versus cost benefits have not been done so far in Indian scenarios. These factors may need to be considered,” he said.