Falola Adebayo Feranmi, Singh Shivangi, Das Upamanyu, Oluwagbemi Ayotemi, Etta Rhoda, Adeyeye Ademola
University of Ibadan College of Medicine, Ibadan, Nigeria.
Muzaffarnagar Medical College, Bahadarpur, India.
J Robot Surg. 2024 Dec 2;19(1):16. doi: 10.1007/s11701-024-02163-7.
Robotic surgery offers several advantages to the African setting, including shorter hospital stays, faster return to work, and increased overall productivity. However, its adoption has been limited by several factors. This review aims to present the barriers to implementation, and recommendations for integrating robotic surgery into the African healthcare system. Use of robotic surgery in Africa is primarily limited to Egypt and South Africa. Barriers faced by other countries were categorized into economic, infrastructural, systemic, and training-related. They include limited healthcare budgets, initial costs of robotic systems, patients' inability to afford robotic procedures, out-of-pocket healthcare financing, inadequate power supply, limited internet connectivity, poor healthcare leadership, and insufficient surgeon training facilities. Public-private partnerships, provision of loans and subsidies, introduction of cheaper robotic systems, and local manufacturing of robotic equipment will serve as cost-effective innovations. It is also important to improve healthcare financing and strengthen healthcare leadership across Africa. To address the lack of surgeon training facilities, remote assistance for surgeon training can be used to create a mentor-mentee relationship between robotic surgeons in any part of the world and surgical trainees in Africa to facilitate knowledge transfer. Prior investment in electricity and network infrastructure is however necessary. Establishment of fellowships to provide early exposure to robotic surgery should also be explored. AI-integrated robotic surgery can also enhance precision and safety, and provide tailored training tools for surgeons. Similar barriers to the adoption of surgical robotics are faced across Africa. By implementing the provided recommendations, robotic surgery can still be widely adopted in African settings, despite the delay.
机器人手术为非洲地区带来了诸多优势，包括缩短住院时间、更快恢复工作以及提高整体生产力。然而，其应用受到了多种因素的限制。本综述旨在阐述实施过程中的障碍，并提出将机器人手术融入非洲医疗体系的建议。机器人手术在非洲的应用主要局限于埃及和南非。其他国家面临的障碍可分为经济、基础设施、系统和培训相关等几类。这些障碍包括医疗保健预算有限、机器人系统的初始成本、患者无力承担机器人手术费用、自费医疗融资、电力供应不足、互联网连接有限、医疗保健领导力薄弱以及外科医生培训设施不足。公私合作伙伴关系、提供贷款和补贴、引入更便宜的机器人系统以及本地制造机器人设备将成为具有成本效益的创新举措。改善非洲各地的医疗保健融资并加强医疗保健领导力也很重要。为解决外科医生培训设施短缺的问题，可以利用远程协助进行外科医生培训，在世界任何地方的机器人外科医生与非洲的外科实习医生之间建立师徒关系，以促进知识转移。不过，事先对电力和网络基础设施进行投资是必要的。还应探索设立奖学金，让学员尽早接触机器人手术。人工智能集成的机器人手术还可以提高精准度和安全性，并为外科医生提供量身定制的培训工具。非洲各地在采用手术机器人方面面临类似的障碍。尽管有所延迟，但通过实施所提供的建议，机器人手术仍可在非洲地区广泛应用。
