Robotic Surgery in Africa: History, Contemporary, and Thereafter.

Abstract

Background: Since its introduction in the late 1980s, robotic surgery has become a less invasive procedure, offering advantages such as increased dexterity, mobility, 3D visualization, and reduced fatigue for surgeons. Although the procedure is still not widely used in Africa, it is fast growing and can potentially minimize surgical inequities in low- and middle-income nations. This narrative review aims to explore the advantages of robotic surgery, its history in Africa, the current level of application of this surgical technique in the continent, the limitations, and how the healthcare system in the region stands to benefit from its use in the future.

Methodology: In this narrative review, extensive literature research was conducted using the Google search engine and databases: ‘Google Scholar’, ‘Cochrane Library’, ‘PubMed’, ‘ScienceDirect’, and African Journals Online (AJOL), spanning 6 months. The search phrases used included: robotic surgery, robotic surgery in Africa, history of robotic surgery in Africa, robotic surgery in low- and middle-income countries, potential advantages of robotic surgery, robotic surgery limitations, benefits of robotic surgery, demerits of robotic surgery, artificial Intelligence in surgical care, and the future of robotic surgery.

A total of 405 articles were found. An advanced search that limited the search to titles revealed only 20 results. Two discussed the possibility of embracing robotic surgery in low- and middle-income countries, one talked about the potential benefits, challenges, and scope of robotic surgery in the future. Also, one talked about the origin of robotic surgery, one delved into artificial Intelligence and its role in surgical care, then discussed the roles of robotic surgery in surgical care, and the rest discussed the few recorded applications of robotic surgery in surgical care in Africa.

Results: Even though the concept of robotics in surgery dates back more than fifty years, its practical application began in the late 1980s. Its enormous potential notwithstanding, the application of robotic surgery on the African continent is still highly underwhelming.  

Admittedly the utilization of robotic surgery in Africa faces many challenges such as the high cost of its acquisition, maintenance, and training needed to use the machine, the upskilling of surgeons to specialize in robotic surgery in each field of expertise, the need to alter the size and layout of pre-existing operating rooms to accommodate the components of the robots and to also increase patient load for the use of the robot to make it effective for the cost price,  it can potentially reduce cost of healthcare, nosocomial infections, antibiotics abuse and surgical inequalities in the Mother Continent.

Conclusion: Our research showed that robotic surgery, despite offering multiple benefits and having the capability to lessen surgical inequalities in resource-poor nations, is still underutilized in the African continent. The study also showed that even though the utilization of robotic surgery faces challenges in middle and low-income parts of the world, like Africa, due to high costs, limited facilities, patient burden, and the need for specialized training. It, however, holds enormous potential in the continent, such as reductions of infections, antibiotic resistance, and hospital stays, and even possibly reduce the costs of healthcare.