Tuesday January 28, 2020
Home Business Robot Assiste...

Robot Assisted Surgery is Linked to The Cost of The Equipment

Robotic assisted surgery has much better postoperative outcomes, but its widespread adoption depends a lot on the reduction in the cost of the equipment

0
//
robotics, surgery, cost-effective, equipment
William Beaumont Army Medical Center performs the first robotic surgery in the Department of Defense using the latest robotic state-of-the-art robotic surgical system, a minimally-invasive robotic surgery system, at WBAMC, May 2. The surgeon-manipulated system allows for surgeons to operate with articulating instruments which bend and rotate far greater than the human wrist through an incision smaller than a centimetre. Wikimedia Commons

Robot assisted surgery has much better postoperative outcomes, but its widespread adoption depends a lot on the reduction in the cost of the equipment, say experts.

While the high cost of a robot, which may range between Rs 6-14 crore approximately, may prevent many hospitals from bringing these advanced technologies for the benefit of patients, training of doctors in carrying out these procedures is equally important.

The US based-Vattikuti Foundation has helped prepare 300 robotic surgeons in India since 2011 by bringing in nearly 150 internationally acclaimed experts in the area to hold master classes, performing and observing live robotic surgeries in eight specialities.

“India has over 300 trained robotic surgeons in eight specialities — gastrointestinal, urology, oncology, head and neck, thoracic, gynaecology, general surgery and bariatric,” Mahendra Bhandari, CEO, Vattikuti Foundation, told IANS.

“Patients in India are willingly opting for robotic surgeries for their treatments. Not only patients, young surgeons are leaving the old way (conventional surgeries) and they want to be a robotic orthopaedic surgeon now,” said Bhandari, while addressing orthopaedic surgeons at a master class on computer-assisted joint replacement surgery here on Saturday.

Mahak Baid, an orthopaedic surgeon from Kolkata said that even though robotic-assisted surgery is an advancement, the only thing that needs to be worked upon is cost-effectiveness.

“In a country like India, robotic surgery has to be economically viable. The robot itself costs a lot. So it is not just about the patients, it has to be economically feasible for the hospital as well,” he added.

However, the doctor said robotic surgeries will eventually grow in India.

“I have been using MAKO robots for the last two years and I’m extremely happy with the results. we’re able to do total hips, total knee and partial knee replacements. With robotics, we can do enhanced pre-planning much better than conventional methods,” Thadi Mohan from Amrita Institute of Medical Sciences, Kerala, told IANS.

“After the robotic surgeries, patients recover faster. Chances of revision become much less. Implants will last longer. There is also a change in the mindset of people as there are now a good number of trained surgeons,” he said.

robotics, surgery, cost-effective, equipment
The only thing holding back robotic-assisted surgeries in India are easy availability. It may take time but eventually it will become cheap and then more people will be able to use it. Wikimedia Commons

“The only thing holding back robotic-assisted surgeries in India are easy availability. It may take time but eventually it will become cheap and then more people will be able to use it,” he stressed.

Bhandari urged global medical devices and pharma firms to bring their technology to the Indian market expeditiously so that the Indian patients do not have to wait for decades to be able to access the most advanced technology, drugs and implants.

When asked about the future of robotics in India, Brian Davis, Professor of Medical Robotics at Imperial College London told IANS that it cannot grow overnight.

“Many of Indian orthopaedic surgeons have been overseas and trained in countries where high-tech systems are quite normal, so they come in and act as mentor for junior Indian surgeons. So, it’s gradually going to come about that you will have more and more experienced mentors but it’s going to take a while,” Davis added.

Many of the orthopaedic surgeons at the conference said that robotics-assisted bone replacement surgeries are far better and safer because of its consistency and precision than the conventional methods.

Joint replacement surgeons cited published studies that revealed that computer-assisted total knee arthroplasty leads to significantly lower blood loss, infections, inflammation and need for revision surgeries.

ALSO READ: Apple Watches, Fitbits to be Used For Patient Care, Study Suggests

“The cost is major factor and rightly so. It takes years to develop this kind of technologies. So by the time they come in practice, the machine costs a lot. Naturally robotic companies with huge investment want to recover their money and India and other developing countries are not their priamary market, Bhandari said.

“The Vattikuti Foundation tries to bring these technologies once they are established. Our model is that we want to exploit the high volumes of the patients in low margins in order to make it cost-effective. And cost should not be major consideration while using a technology, cost is bound to come down the moment the technology used by more and more people,” he said. (IANS)

Next Story

Medicines Also Work Well as Surgeries for Heart Diseases: Study

Hochman co-led the study and gave results Saturday at an American Heart Association conference in Philadelphia

0
Medicines
To doctors’ surprise, study participants who had a procedure were more likely to suffer a heart problem or die over the next year than those treated with Medicines alone. Pixabay

People with severe but stable heart disease from clogged arteries may have less chest pain if they get a procedure to improve blood flow rather than just giving Medicines a chance to help, but it won’t cut their risk of having a heart attack or dying over the following few years, a big federally funded study found.

The results challenge medical dogma and call into question some of the most common practices in heart care. They are the strongest evidence yet that tens of thousands of costly stent procedures and bypass operations each year are unnecessary or premature for people with stable disease.

That’s a different situation than a heart attack, when a procedure is needed right away to restore blood flow.

For nonemergency cases, the study shows “there’s no need to rush” into invasive tests and procedures, said New York University’s Dr. Judith Hochman.

There might even be harm: To doctors’ surprise, study participants who had a procedure were more likely to suffer a heart problem or die over the next year than those treated with medicines alone.

Hochman co-led the study and gave results Saturday at an American Heart Association conference in Philadelphia.

Less testing, invasive treatment

“This study clearly goes against what has been the common wisdom for the last 30, 40 years” and may lead to less testing and invasive treatment for such patients in the future, said Dr. Glenn Levine, a Baylor College of Medicine cardiologist with no role in the research. Some doctors still may quibble with the study, but it was very well done “and I think the results are extremely believable,” he said.

Medicines
People with severe but stable heart disease from clogged arteries may have less chest pain if they get a procedure to improve blood flow rather than just giving Medicines a chance to help, but it won’t cut their risk of having a heart attack or dying over the following few years, a big federally funded study found. VOA

About 17 million Americans have clogged arteries that crimp the heart’s blood supply, which can cause periodic chest pain. Cheap and generic aspirin, cholesterol-lowering drugs and blood pressure medicines are known to cut the risk of a heart attack for these folks, but many doctors also recommend a procedure to improve blood flow.

That’s either a bypass — open-heart surgery to detour around blockages — or angioplasty, in which doctors push a tube through an artery to the clog, inflate a tiny balloon and place a stent, or mesh scaffold, to prop the artery open.

Earlier study

Twelve years ago, a big study found that angioplasty was no better than medicines for preventing heart attacks and deaths in nonemergency heart patients, but many doctors balked at the results and quarreled with the methods.

So the federal government spent $100 million for the new study, which is twice as large, spanned 37 countries and included people with more severe disease — a group most likely to benefit from stents or a bypass.

All 5,179 participants had stress tests, usually done on a treadmill, that suggested blood flow was crimped. All were given lifestyle advice and medicines that improve heart health. Half also were given CT scans to rule out dangerous blockages, then continued on their medicines.

The others were treated as many people with abnormal stress tests are now: They were taken to cardiac catheterization labs for angiograms. The procedure involves placing a tube into a major artery and using special dyes to image the heart’s blood vessels. Blockages were treated right away, with angioplasty in three-fourths of cases and a bypass in the rest.

Doctors then tracked how many in each group suffered a heart attack, heart-related death, cardiac arrest or hospitalization for worsening chest pain or heart failure.

Results are in

After one year, 7% in the invasively treated group had one of those events versus 5% of those on medicines alone. At four years, the trend reversed — 13% of the procedures group and 15% of the medicines group had suffered a problem. Averaged across the entire study period, the rates were similar regardless of treatment.

If stents and bypasses did not carry risks of their own, “I think the results would have shown an overall benefit” from them, said another study leader, Dr. David Maron of Stanford University. “But that’s not what we found. We found an early harm and later benefit, and they canceled each other out.”

Why might medicines have proved just as effective at reducing risks?

Bypasses and stents fix only a small area. Medicines affect all the arteries, including other spots that might be starting to clog, experts said.

Drugs also have improved a lot in recent years.

Having a procedure did prove better at reducing chest pain, though. Of those who had pain daily or weekly when they entered the study, half in the stent-or-bypass group were free of it within a year versus 20% of those on medicines alone. A placebo effect may have swayed these results — people who know they had a procedure tend to credit it with any improvement they perceive in symptoms.

Medicines
Twelve years ago, a big study found that angioplasty was no better than Medicines for preventing heart attacks and deaths in nonemergency heart patients, but many doctors balked at the results and quarreled with the methods. Pixabay

Dr. Alice Jacobs, a Boston University cardiologist who led a treatment-guidelines panel a few years ago, said any placebo effect fades with time, and people with a lot of chest pain that’s unrelieved by medicines still may want a procedure.

“It’s intuitive that if you take the blockage away you’re going to do better, you’re going to feel better,” but the decision is up to the patient and doctor, she said.

ALSO READ: Income Tax Officers Quit Work for Mental Peace

The bottom line: There’s no harm in trying medicines first, especially for people with no or little chest pain, doctors said. (VOA)