Surgical Technology in the Philippines – A Look at 3D and Da Vinci Surgery

Will Da Vinci Surgical Technology Be Popular in the Philippines?

The future of surgical technology means no more incisions. That said, there are no more reasons for patients to go under the knife, when surgery is necessary.

St. Luke’s Medical Center is one of the well-known hospitals, not just in the Philippines, but also in Asia. Recently, they introduced the 3D laparoscopic surgery.

This is not only ideal for complex procedures but patients who just need simple surgery can take advantage of this latest surgical technology at said hospital.

This surgical technology can be performed on biliary, adrenal, hernia and colorectal, among others. If you opt for it, it means less scars.

Hospitalization will also be shorter. Plus, it is safer than the old surgical method.

What is 3D laparoscopic surgery?

It involves the use of various 3D instruments during the procedure. The surgeon utilizes a 3D monitor to look into the patient’s body cavity.

With this advanced surgical technology, doctors will have better viewing of the operative field. As a result, they can make precise and accurate procedure.

Thus, errors involving poor depth perception can be prevented.
  • The 3D image offers excellent perception.
  • For surgeons, it means better accuracy and greater precision.
  • The operating time is also faster. It will be easier for the surgeons to navigate to the targeted organ.
  • Apart from improving the operation’s length of time, surgeons can also work more confidently.

Surgeons at St. Luke’s who will perform the latest laparoscopic surgical technology utilize Dr. Camscope 3D laparoscopic system from Sometech.

The system involves 3D binocular laparascope in navigating the surgical site. Then, doctors will use medical-grade glasses with 3D technology. It is like watching movies in 3D.

The only difference is that doctors are using dark sunglasses that are of medical-grade.

When doctors utilize the 3D monitor, they can easily see the target organ in real distance. The enhanced vision reduces surgical errors, significantly.

The use of this surgical technology has become a trend worldwide.

In the Philippines, there are only a few hospitals that utilize such technology. Unfortunately, Davao Doctor’s Hospital does not have one yet.

What Philippine surgeons are saying about this surgical technology?

Surgeons in the Philippines prefer this future technology than the old method or the 2D technology because of the enhanced imaging.

It is not only limited to gastroenterology but other specialties can also take advantage of it, including urology and gynecology.

It was only in 1993 that the minimally invasive surgical operation, like laparoscopic surgery, was introduced. This future technology brought a great shift in surgery – from an open incision to a simple incision method.

This advanced surgical technology allows men and women to undergo surgical operation with little down time. It means that they can go back to their work, a day or a few days after the operation.

Some patients think that this surgical technology no longer needs surgeons to perform the procedure. But the role of surgeons in this type of procedure is imperative.

Just like the older method, surgeons will still have stand beside the patient to operate them. This would still cause fatigue to the surgeon while performing the procedure.

The overall procedure is considered counterintuitive to the brain. When the doctor inserts the instrument into the abdomen of the patient, the tip goes forward, while the doctor moves the instrument backward.

If it must go left, the doctor must go right. Surgeons are moving the instrument inside the patient’s body while looking at a 3D monitor.

Because of this counterintuitive movement, it took a long time for doctors to get used to it. In fact, there are only a few hundreds of surgeons who are qualified and certified to perform this type of surgical operation.

But the introduction of Da Vinci Robot offers surgeons to easily carry out invasive procedures. The best thing about this surgical technology is that it only requires one to two centimeters incisions.

Features of Da Vinci

The entire machine consists of console, patient cart and vision system.

During the operation, your surgeon navigates and operates while sitting comfortably at the console. He/she views a 3D image of your body’s interior. While operating, your doctor utilizes master controls. They work like forceps.

The Da Vinci surgical technology responds to any type of input your doctor is making. And it responds in real-time. Any wrist or finger movements will be translated into precise movements.

The patient’s cart of Da Vinci can hold up to three EndoWrist instruments, plus a 3D camera. Your doctor uses the EndoWrist instrument to make precise control within your body.

But these instruments are not the only ones being used by surgeons. Instead, there are wide range of instrument types to help them perform the task with precision, accuracy and better control.

Are there complications?

The future of surgical technology may improve the results of a procedure. But it still comes with serious complications. Anything can happen during the operation.

The most serious is death.

Serious complications associated with this type of surgical technology will include the following:

  • Bleeding
  • Injury to the target organ or surround tissues/organs
  • Bleeding
  • Infection
  • Internal scarring which can result in long-lasting pain

The complications can be the result of human error or equipment failure. Hence, it is important to only undergo such operation with a qualified physician.

Those who underwent minimally invasive surgery trough Da Vinci surgical technology system may have the following risks:

  • Temporary pain as a result of positioning
  • Temporary discomfort from gas during procedure
  • Longer operation, which is especially true if your surgeon needs to change from one surgical operation to another surgical technique.

If you are not a good candidate of non-robotic surgical operation, you are also not a good candidate for this type of surgical technology.

There are only 3,000 Da Vinci robots installed and being used all over the world. Most of them are in the US. And there is only one in the Philippines.

When it was approved by the FDA to be used for prostatectomies, a rapid decline in open surgery for the removal of the male prostate was seen.

In the US, 87% percent of prostatectomies are done robotically. But this is not the same in the Philippines. The reason for this is that most patients still prefer the open-wound method because, well, it is cheaper.

However, whether it is performed in the Philippines or not, the complications associated with it must be taken into account.

According to some researchers at the John Hopkins in 2013, some doctors performing Da Vinci surgery did not report or underreport the complications with this surgical technology.

Between 2000 and 2012, there were incidents that occurred in relation to this technology. Some of them involved several deaths and injuries.

In fact, some patients in the US are suing the manufacturer of this robotic technology. They claimed that the product is faulty and must not be on the market.

One man reported to have a routine prostatectomy but he ended up spending 13 hours in the OR, instead of the five hours as he was quoted. To add insult to the injury, he was left incontinent. He also suffered from kidney and lung damage.

Before he passed away, he had sepsis and stroke.

Then another woman was reported undergoing endometriosis through this surgical technology. For nearly 11 hours, she remained in the OR. Then, a few days after the surgery, she was rushed to the ER.

Doctors discovered that she had torn rectum and colon because of this robotic surgical technology.

Surgeons all over the world who performed with Da Vinci said that they experienced serious malfunctions when they used such machine. The FDA revealed that there were one third deaths being reported to them during gynecological procedures.

How much will it cost for you to undergo this type of surgical technology?

According to St. Luke’s Medical Center, the entire cost can be around PHP500,000. To get more people interested in this type of technology, said hospital is offering a promo that let patients take advantage of it a more affordable price.

You can say that it is twice or thrice the price of a laparoscopic surgery. But some would say that it is all worth it.

One of the reasons patients would opt for it is the shorter time it would take for them to stay in the hospital. They will not only be living with a big scar. Thus, most of the patients in the entertainment industry would go for it. Some patients who are following tight work schedules would find this option a more practical choice.

Is the price of this surgical technology cheaper?

You may think that PHP500,000 is a very expensive rate. But, if you compare it to other countries, our rate here is a lot cheaper.

This is why some patients from the US and other parts of the world are coming  here to take advantage of this service. Although it is not yet included in our country’s medical tourism, some people in the government are looking into its benefits.

Still, it is an expensive technology for an average Filipino. This may be the reason DDH is not yet considering it because each robot can cost around $1 million. But the cost will depend on the model. Replacements of its parts can go around $1,500.

Then, the hospital has to pay around $140,000 to maintain it. That said, not all hospitals are opting for it. Doctors are also needed to be trained to perform robotic surgery, which is an additional expense to them.

The extra cost of this equipment and maintaining it will be, of course, passed on to the patient. So, if the ovarian cyst removal will only cost less than PHP 50,000 through traditional laparoscopic surgery, the robotic surgical technology can go three times more than that.

In a Columbian study, researchers revealed that robotic surgical technology costs more than the regular surgical operation. And the complications are greater than opting for the regular minimally invasive surgery.

The makers of this technology are making billions of dollars for one robot. Unfortunately, there is the lack of clinical evidence that this type of technology is more superior than the traditional method.

Nevertheless, the popularity continues to grow. In fact, in 2011, the use of it has increased more than 200 percent of what has been predicted.

If you were to ask a regular person in the Philippines, he/she will just opt for the traditional surgery. Even though it has been predicted that robotic surgical technology will grow exponentially, it may not peak here in the Philippines, where most people are receiving an average salary.

Unless you belong to the elite, your pocket may not be able to handle the overall cost.

It is true that robotic surgical technology is here to stay. But its advantages are only appropriate for those who can afford it.

Newer upgrades will come in to improve its flexibility. They may also reduce the bulkiness of the machine. As a result, surgeons will have better versatility while performing operation. But the overall cost will or may not go down.

This type of surgical technology was once thought to be a science fiction. It was once believed to be a technological stuff that you would only see on Star Trek or Star Wars. But this technology is now a reality.

However, no matter how real it is, the income of Filipinos may not be able to endure the expensive cost of the technology.

Still, this is a wonderful opportunity for us to experience how easy it is to undergo a surgical operation. Hopefully, St. Luke’s Medical Center will offer huge discount to it. And that discount will allow us, regular people, to pay for this expensive technology.

Some insurance companies may not cover it. This is another disadvantage.

If you do have the money to undergo such operation, then by all means take that opportunity. However, make sure that you are a good candidate for it. Bear in mind that not all patients can embrace the benefits of robotic surgical technology, even if they can afford it.

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