Simulation and Control Solutions for Accessible Surgical Robotics in Developing Nations

Robotic-assisted medical procedures have grown remarkably since the late 1980s, demonstrating outcomes comparable to or better than laparoscopic surgery, including reduced blood loss, less postoperative pain, improved cosmetic results, and quicker recovery. Surgeons using robotic systems experience less physiological stress compared to traditional open approaches. The incorporation of robotic surgery allows tele-mentoring and telesurgery. Through telesurgery, surgeons can perform operations from a distance, cutting down on travel time and removing geographical restrictions to enhance surgical productivity. In developing nations with a general lack of healthcare professionals and resources, the expansion of robotic procedures will be a true game changer. Challenges hindering this expansion include fragmentation, high costs, and a steep learning curve, limiting access to smaller hospitals and creating disparities in the training of surgeons. For example, the first urologic robotic system in India was installed at AIIMS, New Delhi, in 2006. Yet, India's global contribution to robotic surgery is less than 0.1%, with only 76 systems across 66 centers and over 500 trained surgeons in 2021. To address these issues, we designed a physical prototype and virtual simulation system. The prototype features three control modes: GUI, joystick, and color-based sorting for two serial manipulator arms, offering flexible training for surgeons. It can also be used in rehabilitation, diagnosis, and other procedures. The virtual simulation provides cost-effective, comprehensive training, reducing the need for expensive installations and accelerating the learning curve. This dual approach makes advanced medical training more accessible and affordable, potentially democratizing robotic surgery for all medical practitioners.