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From Obinna Odogwu, Awka
A fruit seller in Onitsha, the commercial nerve centre of Anambra State, Uche Wilson, stayed off her business for about two months in 2022 after she had a surgery.
She was off business as she needed time to heal properly before returning to the usual struggle and stress associated with every human endeavour, especially her type of business venture.
Given that most times she sourced the fruits she sold from towns and villages that are very far away from the commercial city, she travelled often.
“If you don’t do that, you won’t have fresh fruits to sell to your customers. And you won’t always have varieties of them”, she told Saturday Sun.
But should she need another surgery for whatever reason today, she may not need to stay off her business for that long if she opts for robotic surgery. But she must have the financial muscle to go for it wherever it is offered in the world.
Robotic surgery is a type of minimally invasive surgery during which surgeons use very small surgical instruments that fit into a patient’s body through a series of tiny incisions.
According to a report by the health department of the University of California, Los Angeles (UCLA Health), robotic surgery is currently carried out with the use of the da Vinci™ surgical system, a unique set of technologies that include specialised “arms” for holding instruments and a camera, as well as a magnified screen and a console.
Minimally invasive surgery, when simplified, means smaller incisions, and with it comes a number of advantages which include shorter hospitalisation time and faster recovery for patients.
In addition to that, reports show that there is usually less blood loss and fewer blood transfusions, less scarring, reduced risk of infection, fewer complications during surgery and faster return to normal life by persons who have had robotic surgery across the world.
Again, the surgeon has greater range of motion and dexterity; they see a highly-magnified, high-resolution image of the operating field; has better access to the area being operated on, and there is less pain and faster recovery.
To operate using the robotic system, a surgeon makes tiny incisions in the body of his patient and inserts miniaturised instruments and a high-definition three-dimensional camera, and sometimes skin incisions are not required at all, says UCLA Health.
“Then, from a nearby console, your surgeon manipulates those instruments to perform the operation.
“Think of the robotic system like a supercomputer which allows the machine to translate the surgeon’s movements into real-time allowing for greater precision.
“During a robotic-assisted procedure, your surgeon uses master controls at the surgeon console to direct the instruments during your surgery.
“The computer translates your surgeon’s movements to the instruments that move exactly as the surgeon moves, inside your body.
“Your surgeon is in control of the robot the whole time; the surgical system responds to the direction they provide”, UCLA Health explains.
Unlike the traditional surgery procedures, robotic-assisted surgery requires that the surgeon sits at a nearby large computer called console to direct the procedure instead of standing over the patient.
At the console, the area of operation can be seen highly magnified, with excellent resolution.
Before sitting at the nearby console, the surgeon must have made tiny (one to two centimetre-long) incisions in the body of his patient, insert miniature robotic instruments and a powerful camera into the patient’s body before manipulating the controls from their sitting position at the console.
This way, the instruments respond to these movements, and translate them into precise, real-time movements inside the body of the patient.
“The robotic devices, which have greater dexterity and range of motion than a human, allow your surgeon to successfully perform delicate surgeries in hard-to-reach places”, the UCLA Health adds.
According to reports, robotics has aided a few medical operations since its inception. They include: colorectal surgery, general surgery, gynaecologic, heart surgery, endometriosis, head and neck (transoral) surgery, thoracic surgery and urologic surgery.
The reports add that many conditions have been successfully treated using robotic-assisted surgery in various parts of the world.
Unlike the traditional surgical procedures where a patient would need about a month or more to get back to their work, a patient who had a robotic surgery would go back to their business after about two days, according to reports.
“Every patient is different and you should discuss your recovery with your doctor. In general, patients may stay in the hospital one to two nights and then return home. Most patients find they have recovered fully within six weeks of surgery”, UCLA report says.
This position is supported by Prof. Joseph Ikechebelu, a trained obstetrician and gynaecologist at Nnamdi Azikiwe University, Awka.
Ikechebelu, who is the Deputy Vice-Chancellor (Administration) of the university, described robotic surgery as one of the beautiful innovations in medicine that are actually changing the narratives on how surgeries are carried out.
“You finish surgery today; a major surgery; the person gets up and he is going home the next day. We almost call this one surgical miracle.
“These are normal operations you would have done, the person will stay seven days in the hospital. And when the person even gets out of the hospital after seven days, he still has to recuperate for another one month at home.
“But today, you can do it through this laparoscopy endoscopy method and the person goes home the next day and goes back to his business and everything. So, that’s one good technology that is coming into medicine”, Ikechebelu said.
Although robotic surgery is already popular in the western world, it is still gradually making inroads into Africa. Reports say that South Africa and Egypt are the only countries in Africa utilising the robot in surgical practice.
As of 2021, surgeons have used the da Vinci surgical robot in more than 8.5 million procedures and there are more than 6,700 da Vinci Systems installed in hospitals worldwide, according to Science Direct.
Out of this number, there are only six da Vinci® Surgical Systems currently in use in South Africa while Egypt has only one, reports say.
In South Africa, Tygerberg Hospital in Cape Town was the first government facility to perform robotic-assisted surgical procedures using the da Vinci robot, according to reports; and was acquired at the cost of R40 million.
It said that two colorectal cancer surgeries were performed on Monday, February 21, 2022 using the robot and that the new technology “would help clear up backlogs.”
The hospital management described the successes recorded with the new technology so far as “a good morale booster for surgeons and theatre staff who could showcase their skills and capabilities in the field.”
It added that “it is an opportunity to use state of the art medical technology to improve patient experience and ensure good clinical outcomes.”
“The timing is perfect because, after their surgery, patients have a shorter hospital stay and recovery time, which allows them to get home quicker to be with their families and return to work”, the hospital added.
Unfortunately, the cost of having robotic surgery is expensive and may not be easily afforded by patients in developing countries with not so strong economies.
The estimated per-patient total hospital costs for robotic surgery, open surgery, and laparoscopic surgery (with robot and maintenance costs included) were about $8,770, $7,009 and $6,581, respectively, according to NCBI’s National Library of Medicine.
But with the support of the governments in Africa, right health policies, and the assistance of medical professionals and scientists in the continent, this new health technology can be made more accessible to Africans who may need it.
