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With all the discussion associated with upskilling that is going on in the industry, do you see such upskilling happening in the surgical space in India?

Upskilling for the medical fraternity is a continuous process and this is largely in the area of new research-based medications that are becoming available to treat or manage patients. A large portion of the surgeons who practice in India have obtained training in Laparoscopic surgery and effectively use them for better outcomes for patients. However, it does have its limitations. Today, access to futuristic Robotic-Assisted Surgery (RAS) has paved the way for surgeons to progress from Laparoscopic surgery to advanced RAS.
There is a need to leverage technology to overcome problems of healthcare in India. Without a doubt, the last few years have seen the unprecedented application of technology in the field of medical science and research at the national level.

Why should Robotic-Assisted Surgery be considered as an up-skilling option by surgeons?

I have seen much interest from surgeons to understand more about the benefits of RAS over laparoscopic and open surgeries for the patient, hospital and the surgeon themselves. Surgeons would like the best outcome for their patients when they conduct a surgery. There are multiple studies that show the benefits of RAS in patients, which the surgeon would like to pass on to them if the opportunity is provided to them. Currently, the availability of RAS technology is limited in India and therefore though there is an interest to understand and train in RAS, such options are not easy to come by.
Over 6000 hospitals across the world today performing robotic-assisted surgery compared to less than 100 in India. In order to drive adoption around robotic-assisted surgery amongst the larger unacquainted HCP community in India, there is an acute need for HCP-focused familiarising and upskilling initiatives.

How important is it to upskill surgeons early on in their careers? What are CRSA’s efforts towards that?

With the increase in innovative technology development and adoption witnessed in the past few years, the technology-driven practices are certain to drive the surgical landscape of the country at an even faster pace in the future. Hence, it is important for surgeons to keep up with the pace early in their career itself.
Considering the need and the backlog created during the challenging times, CRSA, along with the leading RAS technology providers, have brought along several initiatives with the aim to increase awareness, familiarise and train the HCP community with the latest in surgical technology. Thereby, we are facilitating a smooth transition through upskilling by employing strategically planned knowledge and training avenues aimed at advancing the surgical landscape in the country in the coming years. We have conducted training programmes on various therapy areas across the country over the last one year.

How many surgeons have you trained in the past couple of years? What are your future plans?

We have directly trained around 250 surgeons in the past year and we are planning to scale up our training programmes in the coming years.

Are you collaborating with technology leaders to up-skill surgeons? What are their role in it?

Of course, we do help and motivate hospitals and robotic technology providers to conduct hands-on training and educatory programmes. They also play a great role in sensitizing surgeons and patients about the benefits of RAS. For instance, Intuitive, a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery (RAS), has been running a campaign called roving robot across the country, with the help of CRSA and various hospitals. As a part of this programme, they conduct hands-on workshops on robotic surgery for medical students and surgeons from medical colleges across India.
Through these kinds of initiatives, we can familiarize the medical fraternity with robotic-assisted surgery, its technology, clinical applications, safety and its benefits.

How has been the patients’ response to robotic-assisted surgeries during the pandemic? What were the reasons for the same?

The pandemic did reduce the number of overall surgical procedures, especially during the time of rising covid cases, but has also sensitized patients to the need of quality healthcare, thus leading to greater acceptance of RAS. In between the waves of COVID cases, the RAS case volumes have picked up, with patients from tier 2 & 3 cities also demanding robotic surgery.
The patients have been wanting to get the best possible technology for their surgical procedures with minimal hospital stay and fastest recovery. The insurance companies have also started reimbursing for the robotic surgery starting October 2020 and has positively impacted the RAS case volumes.

How is the RAS method helping surgeons and patients during the current scenario? What are the advantages of RAS over other methods?

In Robot-assisted surgery, patient and surgeon are separated from each other in distance, thus decreasing the exposure to both of them. There is usually only one bedside assistant in RAS, as compared to 3-4 in laparoscopic/open surgery. Because of this fact, more patients want to undergo robotic surgery as compared to conventional surgery.
Also, minimal access surgery using robotic system leads to faster recovery and less hospital stay, thus reducing the chances of nosocomial infections and getting the patient back to work soon. The increased precision, better visualization in 3D, seven degrees of freedom of instruments and scaling of tremors help surgeons perform a better procedure than conventional surgery using RAS.

You have recently installed Da Vinci RAS surgical technology at Max hospital, Ghaziabad. Do you see this as a trendsetter for other hospitals as well to offer RAS facilities in non-metro cities?

There is a lot of awareness in non-metro cities for advanced medical technology, including RAS. The patients have been traveling to metros for getting these procedures done, which reduced during the pandemic because of travel restrictions. Thus, there is a glaring gap that can be filled by installing this advanced technology in smaller cities.
Max Hospital Vaishali has taken the lead and is the first hospital in the private sector in UP to start a robotic program. It is definitely going to be a trendsetter for non-metro cities, where the actual potential lies in healthcare. It requires a strong clinical and support team along with latest technology, which is there in Max Hospital Vaishali, thus providing all ingredients for a successful robotic surgery program.


Dr. Vivek Bindal