Intuitive Surgical is a global technology leader in minimally invasive care and the pioneer of robotic-assisted surgery. The company established a direct presence in India in the year 2018, and today their technology is used in both government and private hospitals in the country. Mandeep Singh Kumar, Vice President and General Manager, Intuitive Surgical India speaks to Neha Wagle about the da Vinci technology, the growth and future plans. Excerpts:

Can you tell our readers about Intuitive surgical and its mission?
Intuitive India is driven by the belief that minimally invasive care is enhancing lives. The company is dedicated to ensure that its technology expands the potential of physicians to operate without constraints. Intuitive is the designer, developer and manufacturer of the da Vinci robotic-assisted surgical system. Over six million da Vinci procedures have been completed worldwide with over one billion in 2018 alone. Roughly every 30 seconds, somewhere in the world a surgeon performs da Vinci robotic-assisted procedure. Over 40,000 surgeons worldwide have been trained on da Vinci surgical system. There are immense benefits of robotic-assisted minimally invasive surgery which have been explored in more than 18 000 peer-reviewed scientific publications. These benefits include less blood loss, less pain, fewer complications, shorter hospital stays and quicker recovery times. For Intuitive, our mission is keeping patients first. So, for us, first comes the patient, then surgeon, hospital, employee and in last the stakeholder or the shareholder. We go in reverse sequence unlike other companies. If we speak about the success rate, according to me it totally depends on the surgeons and patients. Globally there are 20,000 clinical papers that clearly establish the benefits of robotic-assisted surgeries. The benefits are in two buckets, first is the better clinical outcome and the second is on the patient’s experience.

What is da Vinci? What kind of surgeries can be performed? Tell us more about this technology.
Da Vinci surgical systems are advanced robotic-assisted surgical platforms designed to expand a surgeon’s operating capabilities and offer a state-of-the-art, minimally invasive option for patients. By providing surgeons with superior visualization, enhanced dexterity, greater precision and ergonomic comfort, da Vinci Surgical Systems make it possible for skilled surgeons to perform minimally invasive procedures involving complex dissection or reconstruction. In 2000, the technology became the first robotic-assisted surgical system cleared by the FDA for general laparoscopic surgery. Since then, da Vinci surgical systems have been used in more than six million minimally invasive procedures in surgical specialties including:

  • Urologic Surgery (Male Prostate, Bladder and Kidney)
  • Gynecologic Surgery (Benign and Radical Hysterectomy, Myomectomy)
  • General Surgery (Ventral and Inguinal Hernial repair, Bariatrics)
  • Thoracic Surgery (Lobectomy, Mediastinal Mass)
  • Cardiac Surgery (Mitral Valve Repair, Pulmonary Resections)
  • Colorectal Surgery (Colectomy and Rectal Resection)

The earliest record of da Vinci surgeries in India goes back to 2002 when we had our first system that came in. Currently, we are in our fourth-generation system and we have evolved the technology as we have gone along. Institutions like the AIIMS Delhi, Rishikesh or Jodhpur have been prolific users of the technology. One of our latest installations has been at Safdarjung Hospital, Delhi which was inaugurated by Dr Harsh Vardhan, the Union Health Minister.

What is the difference between robotic-assisted surgery and traditional laparoscopy?
In traditional laparoscopic surgery, the surgeon performs the procedure holding rigid instruments, viewing through an endoscopic camera that is projected on a monitor. With da Vinci surgical systems, the surgeon sits on a console while viewing a 3DHD image of the target anatomy. The machine comprises four, thin robotic arms inserted into strategically placed incisions which are one to two centimeters long. One hand would have a camera, the other three would have instruments. The system seamlessly translates the surgeon’s hand, wrists and finger movements into precise, real-time and tremor-filtrated movement of the surgical instruments positioned inside the patient’s body, which can bend and rotate far greater than either tradition lap instruments or the human wrist.

What is Intuitive’s commitment to India?
In the year 2018, Intuitive established a direct presence in India. Our headquarter office is located in Bengaluru which is their sixth International office. While the decision to go direct was very recent, it was built on a foundation of many years of success and innovation in India. The first da Vinci robotic-assisted surgery took place in India nearly two decades ago – in a Delhi hospital. Prior to 2018, we have spent a number of years providing Indian hospitals, surgeons and patients with access to robotic-assisted surgery through distributors. The decision to “go direct” in India is a reflection of our commitment to and investment in India’s patients, surgeons, hospitals and healthcare systems. There is a real and exciting opportunity for our technology to make a difference for Indian patients, and there is an existing pool of exceptional, committed robotic-assisted surgeons excited about using this technology and the benefits it can convey. Of particular importance to us here in India is not merely introducing the technology – but assuring that we can support our customers in establishing strong robotics programs through everything that surrounds and supports the technology.

We call this our “ecosystem” and we help our customers by ensuring the long-term success of each robotics program. This process starts well before the installation of a robotic-assisted surgical system at a hospital or institution. We evaluate to determine if a program will have the right patient flow, a pool of passionate surgeons who have the right skill and the potential to achieve the right clinical outcomes. We recently opened an additional training center in India, and we aim to provide best-in-class training and support for surgeons there. In addition, we aim to provide Indian robotic surgeons with opportunities to learn from our network of 40,000 trained surgeons across the globe.

What are the future growth plans?
We plan to build a robust presence in India. Our current focus is on hiring employees in sales, support, clinical affairs, marketing, training, regulatory and other areas in order to best support our customers and facilitate access to the technology. We are also trying to take our robotic-assisted surgery to more patients and institutions throughout the country. Intuitive has a very strong mission and vision, driven by global corporate culture, and we are excited to bring that to life here in India. We are working to build our team in order to develop and deliver the tools, technologies and solutions to help improve the lives of patients.

At Intuitive, we put patients first, always – we care deeply about patients and the impact we have on them. We also want to be recognized not only as a company that does good work but as a great company to work for. We count on our team to improve the lives of patients every day – and while we are growing quickly, we are committed to bringing the company’s high standards and culture to India by hiring well, finding the best talent and building a strong, mission-driven team.

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