Robotic Surgeries for Cancer in Low- and Middle-income Countries: Hope or Hype in Surgical Oncology?

Abstract

Abstract Medical sciences and technology have grown exponentially over the past many decades. The doubling time of medical knowledge and technology has shortened from 50 years in the 1950s to just 73 days in 2020. The field of surgical oncology has progressed from open surgery to minimally invasive surgery (MIS). The revolutionary robotic technology has disrupted the space of MIS, with the added promise of better postoperative recovery and improved functional outcomes. This is largely due to reduced pain, fewer infections, lesser blood loss, shorter hospital stay, less scarring, and faster return to normal activities. It is noteworthy that better functional outcomes have been achieved without compromising the oncological principles, as endorsed by multiple studies that have demonstrated the safety, feasibility, and potential short-term advantages of the robotic platforms in surgical oncology. Although robotic surgeries are well established in high-income countries, their use in the low- and middle-income countries (LMICs) is scarce. Overwhelming issues pertaining to cancer care in the LMICs are advanced-stage presentation, barriers of affordability and access, and heterogeneity in the quality of cancer care, among others; hence, advancing the scope of robotics seems to be a low priority. Further, in LMICs, robotic surgeries are invariably offered to affluent populations, further perpetuating the vicious cycle of socioeconomic divide. There are several other challenges to implementing robotic platforms in the LMICs. We attempt to explore the potential solutions and strategies that can be adopted and adapted to overcome these challenges.