Surgery robot at PGI fails to serve desired purpose

Ritika Jha Palial

Tribune News Service

Chandigarh, January 27

The Rs 20-crore surgery robot procured by the PGI in June 2013 has remained underutilised even two months after it was made functional in the Department of Urology, posing a big question mark on the rationale behind its induction. Against the initial aspirations (as projected by the department), the robot failed to help in reducing the waiting list for surgeries and has rather escalated the cost of surgeries by six to 10 times from Rs 5,000 to Rs 30,000-50,000.

While officials at the PGI cite staff shortage as the prime reason for the underutilisation of the robot (just twice a week), they are unable to explain why the availability of staff was not accounted for during the two-year (from 2011 to 2013) propagation for seeking approval for the purchase of the Rs 20-crore machine by the Department of Urology.

“Due to a shortage of manpower (nursing staff, OT technicians, anaesthesiologists and other supportive staff) at present, the robotic operation theatre functions two days a week,” said Dr AK Mandal, Head of the Department of Urology at the PGI.

After the machine remained idle for nearly 18 months, the first surgery was performed using the robot on November 21, 2014. Till date, the robot has performed only 22 surgeries against a total of 400 surgeries performed using laproscopy, with the waiting period for patients still ranging from six weeks to six months.

While the department had decided to perform the first 25 surgeries free of cost (though it involves an expense of Rs 1 lakh per patient), it has now submitted a proposal to start charging patients for conducting surgeries with the help of the robot.

“Information regarding the actual cost of surgical items and the maintenance cost needed for a robotic-assisted surgery vis-a-vis the cost of a similar surgery in other hospitals has been submitted to the hospital charge committee for a decision,” said Dr Mandal.

Sources said the cost of a robotic surgery ranged from Rs 30,000 to Rs 50,000 against Rs 5,000 charged for laparoscopic surgeries when conducted with conventional instruments.

The sources said the office of the Comptroller and Auditor General (CAG) had also questioned the “undue” haste shown by the officials concerned in purchasing the machine without ensuring the availability of infrastructure for running it. The robot could not be utilised from June 2013 to November 2014 due to the unavailability of a specialized operation theatre. Even now, it functions twice a week and performs only two surgeries a day against the five surgeries in a day performed by the same surgeon using laparoscopic instruments.

The sources said more than the advantages of precision in surgery, market-driven forces were responsible for influencing the officials concerned to purchase the machine since this technology found few takers even in developed countries.

Cost of robotic surgery 6 to 10 times higher

• The robot, bought from a company based in the US, remained idle for nearly 18 months (from June 2013 till November 2014) due to the unavailability of a specialised operation theatre.
• So far, the robot has performed only 22 surgeries against a total of 400 surgeries performed using laparoscopy, with the waiting period for patients still ranging from six weeks to six months.
• It runs twice a week and performs only two surgeries a day against five surgeries performed a day by the same surgeon using laparoscopic instruments.
• The cost of a robotic surgery is six to 10 times higher while most patients at the PGI are from economically weaker sections and cannot afford it.
• At AIIMS, New Delhi, robotic surgeries are being performed free of cost since 2010. More than 500 surgeries have been performed so far.