SSI MANTRA Surgical Robotic System: A Testimony to the Indian Indigenous Movement
By Sandhya Mishra
Dr. Sudhir Srivastava
The SSI MANTRA surgical robot, brainchild of cardiac surgeon Dr. Sudhir Srivastava, was developed in Atal Incubation Centre and has successfully completed its first in human clinical pilot study with 18 complex abdominopelvic procedures at the Rajiv Gandhi Cancer Institute in India.
Robot-assisted surgeries have redefined the surgical landscape of several healthcare systems globally. These robots are able to conduct complicated surgical procedures as a surgeon uses a video game–like platform to manoeuvre the device’s various arms and a high-definition camera that is inserted via small holes in the body without the need for slicing the patient wide open.
While surgeons are un-substitutable, the importance of precision cannot be overemphasized, as often, a very slight mistake in placing ligation / incision could result in death of a patient.
India has been importing all of its Robotic systems mostly from US, who has a virtual monopoly in this area. However, for the first time in decades, India's first indigenous and cheapest in the world general robotic surgery system, MANTRA is expected to hit the markets.
Atma-NirBhar Bharat Awardee, SS Innovations is involved in the design and development of an advanced cost-effective surgical robotic system known as MANTRA (Multi-Arm Novel Tele Robotic Assistance) Surgical Robotic System, factored into the grand scheme of things potentiates cost savings, leverage the proficiencies of doctors, results in smaller incisions, shorter hospital stays with lesser pain, scarring and quicker recovery, says Founder and CEO of SS Innovations, Dr. Sudhir P Srivastav.
The renowned robotic cardiothoracic surgeon elaborates on the specifications of MANTRA quoting that it is unique in its ways that it is modular with an open face console. The design provides for superior ergonomics for the surgeon while giving full view of hand controls, foot pedals and surgical team. The surgeon can view the entire operating room for active guidance. Modular Robotic Arms with multiple adjustments are mounted on individual motorised carts for easy movement, positioning and docking. The design allows for total flexibility as to number of arms for specific procedures (3-5 Arms), positioning based on target anatomy and body habitus. The numbers of arms used are customisable based on types of procedures, end-user requirements and budgets.
MANTRA will be useful in all surgical specialties, except orthopaedic at this point and cardiac surgery as one of our focuses. Currently, no other company in the world is focused on all aspects cardiac surgery, specifically robotic cardiac bypass procedures. The benefits in cardiac surgery are huge in terms of having the entire complex operation done through tiny holes versus having the sternum split open, which is associated with a immense trauma, surgical complications, and long recovery periods.
Another major factor that was considered in MANTRA’s development was the cost. The system will be made available at one-third of the cost of the current dominant system in India at the highest level that sells for between 16 to 18 crores.
“What it took really for this success in a relatively short time and with limited financial resources was the association of a clinical experience with a very talented team of young engineers. The majority of this team is from India, while we do have international engineers along the way who have helped us. These are renowned experts in the field of robotic engineering. The SSI team has been aided by world-renowned robotic surgeons and highly experienced consultants from around the world. The committed and focused efforts have resulted in an affordable multi-arm SSI MANTRA Surgical Robotic System that would benefit many more patients around the world to decentralise access and excellence,” he quotes.
Dr. Srivastava elaborates that SS Innovations is planning to make MANTRA commercially available later in 2021. “Our vision is to develop an affordable system that can become available to the masses. Our goal is to be able to sell to the end-user in India at somewhere between INR 4 to 5 crores. This will further keep the cost of procedures as well as the maintenance contract very affordable. The hospitals can afford it and in return, more and more patients will benefit from it. Our plans for the future include establishing our manufacturing and assembly within India. We have raised over 300 crores or so from various resources but at this point. We will be launching our next round of funding for which our goal is to raise somewhere between 700 to 1000 crore to establish the infrastructure support systems, manufacturing and to place ourselves as a global robotic surgery company. My dream and vision are really to make the robotic system available in parts of the world where patients would otherwise not have access. Additionally, we would hope that our system could be placed across Indian Medical Colleges so that, just as surgeons come out of their PG courses as trained laparoscopic surgeons, they could also have the opportunity to train as robotic surgeons as well.”
Dr. Srivastava believes India truly has an opportunity to become world leaders in robotic surgery, with the large population base and desire to advance amongst the medical community along with a huge database based on the cumulative clinical experience that can be used to advance further research & development and teaching and training.
The government support is also necessary to increase the penetration of robotic surgery. Dr. Srivastava lists ways in which Government can support the indigenous movement, as follows:
Reduce the import duty on essential electronic components and other components that are not indigenously produced in India.
Create partnerships to be able to expand healthcare to remote areas.
Robotic surgery coverage under Ayushman Bharat half a billion people
Introduce robotic surgery at educational institutions. This will help the new generation to associate with this revolutionary technology.
Supporting the establishment of robotic surgery programs in public hospitals and putting policies in place that facilitate the adoption and access to the technology.
Providing the required infrastructure to localize the production of surgical robots.
Giving preference to Indian products over foreign-made products if the quality standards are the same.
Promoting indigenous manufacturing of various electronic components, motors, and drives, etc.