Whilst rural India is struggling, small town India is flourishing. Amongst other things, as affluent Indians abandon the public health infrastructure and migrate to well-managed private sector hospitals, robotic assisted surgeries (RAS) are all the rage in smaller Indian cities. Indeed when you get off the flight in these cities, the first advertisement that usually greets you is an upscale hospital offering robotic surgery using equipment from the one of the companies we hold in our Global Compounders Portfolio, namely, Intuitive Surgical (the manufacturer of the famous Da Vinci robots). Sumi Sukunya Dutta’s article says that: “ It is estimated nearly 60,000 robotic-assisted surgeries are now performed in India every year across specialities, with growing popularity in not just metros, but Tier 1 & 2 cities, too.”

Ms Dutta then uses story of one small-town surgeon to outline both the demand-side and supply-side forces at work here: “Dr Magan Mehrotra, a minimal access bariatric surgeon in UP’s Moradabad, about 180 km from the national capital, had been listening to his surgeon friends abroad rave about the benefits of robotic-assisted surgeries (RAS) for years until he found the opportunity to dive into the space himself.

Higher precision, lesser pain to patients, lower blood loss and faster recovery have been among the key reasons that surgeons across the world have rapidly switched to RAS—a surgical procedure that uses a robotic device under the guidance of a trained surgeon. But the exorbitant cost of the surgical robots, estimated at around Rs 15-20 crore, held Mehrotra back from realising his ambition of adopting the cutting-edge technology for his work.

“I work in a Tier 2 town, where the paying capacity of patients is not as high as those in the metropolitan cities. So, going for an expensive technology was not a feasible option,” he says.

Last year, however, he came across a proposal to install a made-in-India surgical robot at one-fourth the price of other imported devices available in the country. The surgeon did not have to give a second thought.

Since July 2023, the robot installed at Apex Hospital, a 110-bed facility co-founded by Mehrotra, has been used to perform 300 surgeries across specialities, like general surgery, gynaecology and urology.

Even though RAS comprises just 10 percent of the total surgeries that he carries out every month, Mehrotra says that he is surprised at the tremendous response from patients that the technology has received. “The demand is growing quickly because of the many advantages it offers,” he tells ThePrint…While RAS is gaining popularity in mega cities, its adoption is rapidly taking flight in Tier 1 and 2 cities, too.

Healthcare industry insiders say that between 2002 and 2019, hospitals in the country saw installation of just about 50 robotic systems. But this number has grown to over 300 now and is rising every month.

Leading companies offering the surgical robots in India include US-based Intuitive Surgical, American-Irish medical device company Medtronic, British devicemaker CRM Surgical, and SS Innovations (SSI), an Indian company which makes indigenous surgical robots.”

1500 surgeons across India now perform RAS and with patient outcomes from RAS being better than from conventional surgery (because the incisions are more precise), it is safe to expect affluent Indians to make a beeline for hospitals which offer RAS.

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