The Brazil that works: with fewer risks, robotic surgery grows in the country

RIO DE JANEIRO, BRAZIL – Technology is the ally of many health professionals to improve efficiency in patient treatment and reduce costs. Robotic surgery, launched in the year 2000, is growing increasingly in Brazil, which has 75 pieces of equipment spread throughout all regions. The country ranks ninth in the world in installed capacity.

Despite having a high installation cost – US$3 million (about R$16 million) – the investment pays off, especially in prostate cancer surgeries. Doctor Renato Almeida Rosa de Oliveira, surgeon at the Instituto de Urologia, Oncologia e Cirurgia Robótica (IUCR) and at the Uro-Oncology department of the BP – Beneficência Portuguesa Hospital of São Paulo, conducted a study to evaluate whether the benefits are worth the high cost of the equipment.

The analysis was done with 205 patients, who needed to undergo treatment for prostate cancer, over a period of five years. In this sample, 56 patients underwent robotic surgery and 149 patients had the so-called radical retropubic prostatectomy, without the use of the robot. “To analyze how cost-effective each treatment is, we consider all investments in primary treatments, complementary treatments, salvage, complications, and follow-up tests,” he explains.

Although the investment in robotic surgery is high, the cost-effectiveness analysis showed an advantage in using surgery that is considered less invasive. The data pointed out that these patients presented twice less urinary incontinence complications and three times less erectile dysfunction, with costs within the parameters established for the Brazilian economy.

In other words, the initial cost of acquiring the equipment is offset by the reduction in other complications and secondary treatments. This is largely due to the benefits of the equipment. The main one is to have millimeter precision, because the doctor’s field of vision increases up to 20 times.

Robotic surgery in the world

Worldwide, about 1.2 million robotic surgeries are performed annually. In 2019 Brazil performed 13,000 procedures and was on an upswing with more surgeries. Half of this number was urological surgeries alone, mainly to treat prostate cancer.

Gustavo Guimarães, director of the IUCR and coordinator of the Surgical Oncology Departments of the BP – The Beneficência Portuguesa Hospital of São Paulo, explains that the covid-19 pandemic curbed this increase, but not that of machine acquisition. In his estimate, the country should arrive by the end of the month with 80 equipments.

“Almost 10 years ago all robots were in Brazil’s Southeast. Now we have them in all regions. They are not only in the capital cities, but also in the countryside. We should have 100 to 120 robots if it weren’t for the pandemic. Compared globally, we are in a privileged position”, he evaluates.

Source: Exame