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ARE ROBOTIC SURGICAL SYSTEMS SUSTAINABLE METHOD OF MINIMALLY INVASIVE SURGERY FOR HEALTHCARE SYSTEMS OF DEVELOPING COUNTRIES – CAN BENEFITS JUSTIFY HIGH COSTS?

by | Dec 9, 2019 | DOI 2018

Sara Gračić
PhD student of business informatics, Faculty of Economics, Segedinski put 9-11, 24000 Subotica, Serbia
Zoran Ćirić
Faculty of Economics, Segedinski put 9-11, 24000 Subotica, Serbia
DOI: https://doi.org/10.31410/EMAN.2018.909
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2nd International Scientific Conference – EMAN 2018 – Economics and Management: How to Cope With Disrupted Times, Ljubljana – Slovenia, March 22, 2018, CONFERENCE PROCEEDINGS published by: Association of Economists and Managers of the Balkans, Belgrade, Serbia; Faculty of Management Koper, Slovenia; Doba Business School – Maribor, Slovenia; Integrated Business Faculty –  Skopje, Macedonia; Faculty of Management – Zajecar, Serbia, ISBN 978-86-80194-11-0

Abstract​

In 2001 first transatlantic robotic surgery on a human was successfully conducted. Since, developed countries have started implementing robotic surgical systems, providing patient/doctor benefits, but with significant costs, which focuses our research on possibility of implementing these systems in developing countries as well. Robotic surgeons help perform complex procedures with greater accuracy, flexibility and control, compared with conventional techniques. They are correlated with minimally invasive surgery due to small incisions, but can sometimes be used in open (invasive) procedures. System consists of 3 units: slave, with 3 to 4 robotic arms for surgical instruments and camera; master console, where surgeon is located and manages the arms by movement and voice and monitoring unit. Surgical robots cover diverse medical areas: general surgery, urology, gynaecology and have been in focus of studies that investigated various metrics, of which most important success and complication rates. Some measured system set-up, console and procedure time. Others calculated material and personnel costs for different procedures. A study compared prices and technical characteristics of 2 commercially available robots, da Vinci and Radius. Benefits of robotic surgery: patients have small incisions, some not even visible, postoperative recovery is faster, there is less blood loss and element of aesthetics. Doctors can easily reach different parts of the body, having a feeling they are “inside a patient”, the system is ergonomically suited to support their body and learning curve is fast. However, robot is not the best alternative for gynaecological procedures – complication rate is slightly higher than with laparoscopy and it costs a lot more. Surgical robot costs a few million dollars, it has to be maintained every year, generating expenditure of hundred thousand dollars, each instrument must be changed after 10 uses, if it lasts that long, meaning another few hundred dollars per every changed instrument. Doctors have to be trained on simulators to use these systems, which generates expenditures of going to education centres. There are doctors who are refusing these technologies as well as patients. The purpose of conducting this research is to answer the main question: can developing countries implement this technology, bearing in mind patient/doctor benefits with high expenditures? After analysing benefits, risks and costs through relevant papers from scientific databases and noticing resource reallocations were made in Serbian budget, it is concluded that financial resources could be obtained for implementing this system. However, potential threat lies within rejection of new technology by patients and possibly doctors. Therefore, system implementation should be shaped in the following way: educate citizens and doctors via social media campaigns first and then conduct acquisition of the robot parallel with medical staff training. Only then implementing this expensive robot can be recommended.
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Key words

surgical robots, costs, benefits, sustainability, process
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Gračić_Ćirić_ARE ROBOTIC SURGICAL SYSTEMS SUSTAINABLE METHOD OF MINIMALLY INVASIVE SURGERY FOR HEALTHCARE SYSTEMS OF DEVELOPING COUNTRIES – CAN BENEFITS JUSTIFY HIGH COSTS_pp_909-920Download
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