DR. SUDHIR PREM SRIVASTAVA
How is India positioned in innovations and technology in medicine and surgery?
Medical technology and innovations in India are riding the growth curve. Technology-led innovations are helping penetrate second- and thirdtier markets. A government-led push to get health care providers to embrace electronic medical records is enabling artificial intelligence (AI) to extract insights from patient data to deliver better treatment. The availability of telecom bandwidth is making medical expertise reach underserved rural markets through telemedicine and tele-consulting programs. Technology has also helped bring efficiencies in areas like CT scans, such as better images and faster diagnosis. The
Indian government’s ‘Make in
India’ initiative is encouraging domestic manufacture of medical
devices and helping lower the prices patients pay for products such as stents and implants, which in the past were imported. Telesurgery is an emerging advancement utilizing wireless networking and robotic technology to connect surgeons and patients who are distantly located from one another.
Despite its shortcomings, India’s healthcare sector has a lot going for it on several fronts. At the same time, there are certain key enablers like funding, talent, supportive regulation and indigenous manufacturing that will further facilitate and drive the process of innovation in healthcare. These will together create the right environment, including resources and incentives, needed for incessant medical technology innovation and enhancement of the quality and effectiveness of care.
Tell us about the launch of MANTRA. How much time did you take to take from inception to getting the product ready?
Despite decades of successful robotic-assisted surgeries globally that have positively impacted millions of patients, access is scarce at large. The dominant current robotic system is expensive and associated with a steep learning curve, resulting in limited availability across the world. Taking this up as a challenge and leading with a vision to offer minimally invasive robotic surgery solutions, we have launched the MANTRA surgical robotic system. It is a cost – effective, modular surgical robotic system developed to perform minimal access surgery with high precision, control & dexterity. It can be utilized for all major surgical specialties including Urology, General Surgery, Gynaecology, Thoracic, Cardiac, and Head & Neck Surgery.
I came to India as founder and chairman of the International Centre for Robotic Surgery to be able to launch programs in the country. After having come to India in 2011 and launching programs, I realized that the cost was a major inhibiting factor for our patients to undergo surgery. The capital cost was high and the per procedure cost was also expensive. In 2012, I decided to invest my time and money to come up with a system that would be cost-effective. Initially, my mission took me to Germany, and then in 2013, I put together a team of engineers to start looking into developing some of the ideas that were very different for a technologically different robotic systems that would also be cost-effective and have more capabilities.
It has taken us about four years or so, to come up with the latest generation of the MANTRA surgical robotic system. Recently, in our first in human clinical pilot study utilizing the MANTRA surgical robotic system, we successfully completed 18 complex abdominopelvic procedures at the Rajiv Gandhi Cancer Institute, the premier hospital for Oncology Surgery in India.
Tell us about your team, who worked on this project?
What it took really for this success in a relatively short time and with limited financial resources was the association of a clinical experience with a very talented team of young engineers. The majority of this team is from India, while we do have international engineers along the way who have helped us. These are renowned experts in the field of robotic engineering. The SSI team has been aided by world renowned robotic surgeons and highly experienced consultants from around the world. The committed and focused efforts have resulted in an affordable multi-arm Mantra Surgical Robotic System that would benefit many more patients around the world to decentralise access and excellence.
What differentiates MANTRA from the existing Robotic system in the market?
MANTRA is unique in its ways that it is modular with an open face console. This design provides for superior ergonomics for the surgeon while giving full view of hand controls, foot pedals and surgical team. The surgeon can view the entire operating room for active guidance. Modular Robotic Arms with multiple adjustments are mounted on individual motorised carts for easy movement, positioning and docking. The design allows for total flexibility as to number of arms for specific procedures (3-5 Arms), positioning based on target anatomy and body habitus. The numbers of arms used are customisable based on types of procedures, end user requirements and budgets.
Our system will be useful in all surgical specialties, except orthopaedic at this point. Additionally, we will be including cardiac surgery as one of our focuses. Currently, no other company in the world is focused on all aspects cardiac surgery, specifically robotic cardiac bypass procedures. The benefits in cardiac surgery are so huge in terms of having the entire complex operation done through tiny holes versus having the sternum split open, which is associated with a lot of trauma, surgical complications, and very long recovery periods.
Another major factor that we considered in this development was the cost. The current dominant system in India at the highest level sells for between 16 to 18 crores. As mentioned, our vision is to develop a system that can benefit the masses and many more hospitals, as such, our system will be available at on-third of that cost.