Intuitive Surgical India: Giving An Arm To Surgeons

Amid the technology pool, Healthcare sector witnesses another technological boom entering the operation theatres of Indian hospitals, i.e., Robots performing Robotic-assisted surgery (RAS). BW Businessworld interacted with Mandeep Singh Kumar, Vice President and General Manager of Intuitive Surgical India, the makers of da Vinci system, the latest technology available in RAS.

Here is the excerpt:

How differently Indian patients and Doctors are taking Robotic surgery from the US/UK? How is the market across the world?

Robotic-assisted surgery (RAS) has made a meaningful impact in India, reaching thousands of patients throughout India since the first in-country procedure took place at a hospital in Delhi in 2002. Compared to markets like the US, where RAS is more broadly used, RAS adoption in India is in an earlier phase. However, it has enormous potential - India is a country where innovative healthcare technology has the potential to contribute to the healthcare system and improve lives, and it is exciting to see how RAS has become a part of that story.

Indian surgeons have played a critical role in the adoption and evolution of robotic-assisted surgery globally and in India throughout Intuitive’s 25-year history. Indian surgeons have rapidly adapted to the technology, and there is now a pool of talented, passionate RAS surgeons with high patient volume throughout India.

Globally, RAS continues to be adopted by surgeons around the world and in different speciality areas. Currently, there are over 5,500 da Vinci systems in 67 countries. More than 7.2 million RAS procedures have been performed on da Vinci Surgical Systems, with 1.2 million taking place in 2019 alone. In addition, more than 52,000 surgeons have been trained on the da Vinci robotic-assisted system worldwide.

Intuitive surgical is a major contributor to the robotics surgery. How do you plan to expand in the Indian market?

We see an exciting opportunity for surgeons in India to use our robotic-assisted surgical systems to make a difference for their patients. Intuitive is building a robust presence in India to meet and support growing interest and demand. To strengthen our presence, we have invested in training centres, and are hiring employees, including teams that work closely with surgeons and to support hospitals for the long run. We currently have over 70 systems in India and have trained over 500 surgeons.

In addition to expanding our in-country capabilities, India’s growing community of passionate RAS surgeons will also play a central role in its adoption throughout the country as they continue to share their personal experience providing RAS as an option for their patients, and collaborate with their peers in the country and throughout the globe.

The 2019 launch of the Indian Chapter of the Clinical Robotics Society Association (CRSA), a global association dedicated to RAS surgeon training, and now the first Indian robotic surgical society, was a recent sign that the community of enthusiastic RAS surgeons in India is growing and becoming increasingly influential.

Using robots for surgery definitely increases the overall cost. How long do you think it will take for it to be normalized and affordable?

While RAS is in an earlier stage of adoption in India, the use of technology globally is widespread and well established. For instance, every 26 seconds, somewhere in the world, a surgeon starts a da Vinci procedure.

Intuitive works with a wide range of hospitals, and offers a range of systems at different price points and flexible purchasing terms, which we use to help individual customers develop robotic-assisted surgical programs that meet both their clinical and economic goals.

Can you elaborate more on the da Vinci system?

da Vinci surgical systems are advanced robotic-assisted surgical platforms. The technology was created to expand a surgeon’s operating capabilities and offer a state-of-the-art minimally invasive option for patients.

Our systems have pioneered new capabilities in the OR, transforming the field of minimally invasive surgery. The da Vinci is currently on its fourth-generation model, which is in use in India.

By providing surgeons with superior visualization, enhanced dexterity, greater precision and ergonomic comfort, da Vinci technology makes it possible for skilled surgeons to perform procedures involving complex dissection or reconstruction with minimal incisions, scarring, blood loss and complications. The da Vinci robotic-assisted surgical system also scales, filters, and translates the surgeon’s hand motions into more precise movements, and its instruments bend and rotate with greater dexterity than the human hand, and can offer enhanced access to the surgical site.

In terms of revenue, how Indian markets are contributing to Intuitive?

We believe robotic-assisted surgery has a bright future in India, which is why we established a direct presence in India in 2018, a sign of our long term commitment to the country.

While we do not comment on country-specific revenue figures, our business is driven first and foremost by a focus on “patients first”. We think in terms of how we can build successful robotic-assisted surgical programs at hospitals that will serve patients over the long run, and how we can provide an ecosystem of services, ranging from surgeon training to data analytics, that can support that process.

How AI and ML are making an impact in the healthcare sector?

There is a lot of talk about AI and machine learning and how they are being applied to a number of technologies. We understand that these concepts will take time and care to develop in healthcare, especially in surgery. At Intuitive, we invest heavily in R&D in a number of areas with an eye to the future. This includes the application of AI and ML to identify optimal approaches to surgery or different tasks within surgery, which can have application for simulation exercises for surgeons and care teams.

In terms of the future, we will want to see that any advances we make will make real improvements in clinical outcomes or the patient or surgeon experience.

What is the current need of the country?

The demand for robotic-assisted surgery in India has, in part, been driven by the same factor that has driven adoption globally: a desire to offer a minimally invasive option that can improve patient outcomes. Compared to other more invasive methods, robotic-assisted surgery can provide surgeons with additional capabilities, such as superior visualization, enhanced dexterity, greater precision, and the ability to operate through small incisions, which can make surgery easier on patients. The benefits to patients from minimally invasive, robotic-assisted surgery can include fewer complications, less pain and scarring, less blood loss and faster recovery – essentially getting patients back to their lives faster.

These benefits can create dividends for hospitals in India – faster recovery can mean shorter hospital stays and fewer readmissions, freeing up a limited supply of hospital beds and helping take the pressure off the overall healthcare system.

Today we see a high incidence of cancer among the general population and based on a recent WHO report, cases of cancer are projected to rise in India. One of our focus areas is procedures tied to critical types of cancer, primarily around the specialities of urology, gynaecology, and general surgery, and we see the high utility in that space in the future.

What are the future growth plans in India?

We are focused on hiring talented employees in sales, support, clinical affairs, marketing, training, regulatory and other areas in order to best support our customers and facilitate access to, and adoption of, robotic-assisted surgery to more patients and institutions throughout the country. Intuitive has a very strong, mission-driven global corporate culture, and we are excited to bring that to life here in India, working to build our team in order to develop and deliver the tools, technologies and solutions to help improve the lives of patients.

Our investment in training centres, a clinical sales team that works closely with surgeons, and a capital sales team collectively enable us to maintain the supportive ecosystem for the hospitals over the long run. We aim to provide best-in-class training and support for surgeons here in India throughout their careers – from initial exposure to the technology to more advanced training.