The Dawn of Surgical Robotics in India

India stands at the cusp of a medical revolution, where technology and human expertise converge to create extraordinary possibilities in healthcare. Surgical robotics—once a futuristic concept—is now a reality in India's top hospitals. Over the past decade, robotic-assisted surgeries have seen a steady rise, offering a minimally invasive, highly precise option across specializations. From cardiac and urological procedures to cancer surgeries and orthopedics, robotic systems are redefining surgical excellence. Surgical robots have enhanced surgeons' dexterity by eliminating hand tremors and significantly expanding the range of motion of surgical instruments. As a result, they have minimized the negative effects of invasive procedures, leading to shorter hospital stays.

How Surgical Robotics is Transforming Indian Healthcare

Since 1985 when the first surgical robot, the Puma 560 was introduced the medical field has increasingly turned to robotic surgery to improve precision and patient safety. The integration of robotics into surgery is not merely a technological leap; it’s a transformation in patient care. Robotic systems allow for unparalleled precision, reduced trauma, quicker recovery times, and better clinical outcomes. The earliest surgical robots, known as “stereotaxic robots,” were developed to assist in performing highly precise brain biopsies. Notable examples from this first generation include the SCARA robot, ROBODOC, and AcroBot. In India, the use of surgical robots is bridging the gap between global best practices and accessible, high-quality care. Over the past 12 years, robotic-assisted surgeries have been successfully performed in India more than 12,800 times.

Key Applications

• Urology: Robotic systems have revolutionized urological procedures by enabling surgeons to perform complex operations such as prostatectomies (removal of the prostate gland) and partial or total kidney surgeries with enhanced precision. The improvement in dexterity helps in delicate nerve-sparing techniques, which are useful in preserving urinary and sexual function. Robotic assistance also minimizes blood loss and shortens recovery times for patients undergoing treatment for conditions like prostate cancer and kidney tumors.
• Gynecology: In gynecology, robotic surgery is commonly used for hysterectomies (removal of the uterus) and myomectomies (removal of fibroids). The technology allows surgeons to operate through small incisions, reducing pain and scarring compared to open surgery. This approach is particularly beneficial for complex cases involving large fibroids or endometriosis, offering patients quicker recovery and better preservation of reproductive organs where applicable.
• Oncology: Robotic-assisted surgery plays a critical role in cancer treatment by enabling precise tumor removal with clear margins while sparing surrounding healthy tissues. This is crucial in cancers where organ function preservation is vital, such as in bladder, lung, colorectal, and head and neck cancers. Enhanced visualization and fine instrument control reduce complications and improve post-surgical outcomes, including faster return to normal life.
• Cardiothoracic: In cardiothoracic applications, robotic systems assist in minimally invasive procedures like heart valve repair and coronary artery bypass grafting (CABG). Intricate maneuvers in confined spaces are required for these surgeries. Robotics facilitate access through small incisions between the ribs, avoiding the need for large chest openings. Patients benefit from reduced pain, less blood loss, shorter hospital stays, and quicker rehabilitation.
• General Surgery: Robotic surgery enhances common general surgical procedures such as hernia repairs and cholecystectomies (gallbladder removal). The precision of the robotic arms allows for better tissue handling and suturing in delicate areas, reducing recurrence rates and postoperative discomfort. Patients typically experience shorter hospital stays and faster return to normal activities compared to traditional open surgery.
• Orthopedics: In orthopedic surgery, robots aid in joint replacement procedures by improving implant positioning and alignment accuracy. This technology reduces the risk of implant failure and enhances joint function post-surgery. Robotic assistance in knee and hip replacements also leads to more personalized surgery tailored to a patient’s unique anatomy, contributing to better mobility and longer implant lifespan.
• Head & Neck Surgery: Transoral robotic surgery (TORS) is a minimally invasive technique used to treat tumors in the mouth and throat. By accessing the surgical site through the mouth, TORS avoids external incisions and reduces complications. The robotic system provides surgeons with enhanced visualization and precise control, allowing for effective tumor removal while preserving vital structures related to speech and swallowing.

Benefits of Robotic Surgery

• Precision: Enhanced Visualization and Dexterity
  Robotic surgical systems provide surgeons with high-definition, 3D visualization of the operating field, allowing for enhanced depth perception and magnified views of anatomical structures. The robotic arms provide excellent dexterity, mimicking and even exceeding the range of motion of the human hand. This level of control allows for microscale movements and highly accurate incisions, especially in complex or delicate procedures such as cancer excisions or cardiac surgeries.
• Minimal Invasiveness: Smaller Incisions, Reduced Bleeding
  Robotic surgery is typically performed through a few small keyhole incisions rather than large open cuts. This minimally invasive approach reduces blood loss during surgery and lessens the trauma to surrounding tissues. Patients experience less postoperative pain, reduced need for pain medications, and fewer complications related to wound healing.
• Faster Recovery: Shorter Hospital Stays, Quicker Return to Routine
  Because robotic surgery causes less trauma to the body, patients often recover faster than those who undergo traditional open surgery. They can expect shorter hospital stays, earlier return to daily activities, and reduced time away from work. This not only improves quality of life for patients but also reduces the overall burden on healthcare systems.
• Reduced Complications: Lower Infection and Readmission Rates
  Minimally invasive robotic procedures result in lower risks of surgical site infections, blood clots, and other complications. The improved precision reduces unintended tissue damage, while smaller incisions mean less exposure to pathogens. Consequently, the likelihood of postoperative readmission and reoperation is significantly lowered, contributing to better long-term outcomes.
• Ergonomics for Surgeons: Less Fatigue, Greater Control
  Robotic systems are designed to improve surgeon ergonomics by allowing them to operate from a seated console, using hand and foot controls with minimal physical strain. This arrangement minimizes fatigue during extended procedures and improves concentration, enabling surgeons to carry out complex surgeries with increased stability and confidence. Over time, this could improve both surgical performance and the longevity of surgeons’ careers.

India’s Unique Position in Surgical Robotics

India is uniquely positioned to lead in surgical robotics due to a blend of skilled surgeons, expanding infrastructure, growing tech startups, and an increasing number of patients from both India and abroad. In 2000, the All-India Institute of Medical Sciences (AIIMS) in New Delhi became the first institution in India to acquire a surgical robot. Since then, the adoption of robotic systems has steadily grown. By 2021, India had approximately 76 fully operational surgical robots and more than 500 surgeons trained in robotic surgical techniques. Meril‘s robotic surgery system CUVIS, is India’s first robotic surgery system, and first fully automated joint surgery robot4. The system is equipped with a highly precise milling cutter that, when used alongside personalized pre-surgical planning, minimizes surgical side effects and ensures more predictable outcomes. Additionally, CUVIS prioritizes patient safety through its Bone Motion Monitor, which can detect even the slightest patient movement during the procedure and automatically halt the operation to prevent complications.

Indian companies are making significant strides in the field of surgical robotics, driven by innovation and the goal of making advanced medical technology more accessible. One notable example is SS Innovations, founded by robotic surgery pioneer Dr. Sudhir Srivastava. This company has developed the SSI Mantra, India’s first indigenous surgical robot, which stands as a testament to the country’s growing capabilities in medical technology. It has been deployed at several prominent centers, including the Rajiv Gandhi Cancer Institute in New Delhi, Sanjeevani CBCC USA Cancer Hospital in Raipur, Continental Hospital in Hyderabad, Hindusthan Hospital in Coimbatore, and Cytocure Hospital in Mumbai.

• Indigenous Innovation
  The SSI Mantra is designed to provide a cost-effective alternative to expensive international robotic systems, which often come with prohibitive price tags and high maintenance costs. By focusing on affordability without compromising on precision and safety, SS Innovations aims to democratize access to robotic surgery across both public and private healthcare sectors in India. This homegrown platform not only reduces dependence on imported technology but also fosters self-reliance under initiatives like Make in India.
• Affordability
  Despite the significant initial investment required for robotic surgical systems, India manages to offer robotic surgeries at a fraction of the cost compared to Western countries. This affordability is driven by several key factors that work in tandem to make advanced surgical care more accessible to a broader population.
  
  One major contributor is the efficient collaboration between the public and private healthcare sectors. Public hospitals, often supported by government funding, provide subsidized or low-cost surgeries, while private hospitals bring in advanced infrastructure and cutting-edge technology. These public-private partnerships help optimize resource utilization, reduce overhead costs, and improve service delivery, ultimately lowering the overall cost of robotic surgeries for patients.
• Medical Tourism
  India has become a global hub for robotic surgery. Patients from Africa, the Middle East, and Southeast Asia travel to India for advanced care at lower costs, high-quality infrastructure, and world-class surgeons. Medical tourism especially for robotic surgeries, is fueled by a substantial cost advantage over Western nations, the presence of highly skilled surgeons, and the widespread adoption of advanced surgical technologies.
• Government Support
  Initiatives like Make in India, coupled with health insurance reforms (e.g., Ayushman Bharat), are slowly paving the way for wider adoption of surgical robotics in tier-2 and tier-3 cities. These programs are not only promoting domestic manufacturing of advanced medical technologies but also working to expand access to affordable, high-quality care across socio-economic segments. The Make in India campaign encourages indigenous production of medical devices and robotic platforms, reducing dependency on costly imports. This has spurred the development of homegrown solutions like the SSI Mantra, which are more affordable and specifically tailored for Indian healthcare settings.

Challenges Holding Back Growth

• Cost
  Robotic systems like the da Vinci Surgical System are expensive, limiting adoption to high-end hospitals. Maintenance costs, such as software updates and hardware repairs, contribute to ongoing expenses. Additionally, training surgeons and operating room staff in robotic surgical techniques represents a significant investment.
• Training
  Robotic surgery requires extensive training. There is a lack of sufficient certified training centers and simulation-based programs for surgeons and residents in India. A major challenge is the absence of a standardized curriculum, structured training programs, and regulatory oversight. The main type of training provided consists of sponsored courses, which are typically required before surgeons can clinically operate robotic platforms; however, concerns have been raised regarding the competency of surgeons trained through these programs.
• Awareness
  Awareness of robotic surgery has yet to reach a widespread level in India. Patients often remain unaware of robotic options or perceive them as prohibitively expensive or experimental. Moreover, social media and advertisements may falsely skew patients’ understanding.
• Infection Risks
  While robotic surgery is generally safer, inadequate sterilization protocols and inexperienced teams can elevate infection risks, especially in smaller centers.

Ethical Concerns

• Equity of Access: The implementation of robotic surgery in rural areas brings forth ethical and legal challenges, especially regarding patient consent, data privacy, and the responsibility of remote surgeons. To safeguard patient well-being, a comprehensive regulatory framework is essential to address these issues effectively.
• Informed Consent: Patients may not fully understand the risks and limitations of robotic surgery. This often results from inadequate communication and patient education, leading to misconceptions and unrealistic expectations about the procedure and its potential outcomes.
• Surgeon Autonomy vs. Machine Control: Balancing AI assistance with human judgment remains a debate. The distinction between the autonomy of AI-driven tools and human responsibility in surgical decision-making can often seem unclear. A key challenge in AI-assisted emergency surgery is ensuring continuous human oversight while effectively utilizing the strengths of AI technology.
• Data Privacy: As robotic systems become more advanced and widely adopted in surgical procedures, they are increasingly collecting vast amounts of surgical metrics and patient data. This growing reliance on data-driven technology raises significant concerns about data privacy and security. Sensitive information, such as patient medical histories, real-time surgical footage, and procedural outcomes, is stored and transmitted through digital networks, making it vulnerable to potential breaches or unauthorized access. Ensuring robust cybersecurity measures, secure data storage protocols, and compliance with health data regulations is essential to protect patient confidentiality and maintain trust in robotic surgical systems.

The Future of Surgical Robotics in India

Emerging Technologies

• AI-Assisted Surgery: Machine learning will refine real-time decision-making.
• Tele-robotics: Remote surgery may soon become viable for rural India.
• Haptic Feedback: Haptic feedback plays a critical role in advancing robotic-assisted surgery by restoring the sense of touch that is often lost in minimally invasive procedures.

Cost Reduction

Indigenous systems and volume-driven pricing models will help bring down costs, making robotic surgery more widely available.

Training Expansion

Dedicated institutions such as the Vattikuti Foundation, along with various e-learning platforms, are playing a pivotal role in shaping the future of robotic surgery in India. These organizations are not only providing hands-on training and mentorship to aspiring surgeons but also fostering a culture of innovation and continuous learning. By offering workshops, fellowships, simulation-based training, and virtual classrooms, they strive to close the gap between traditional surgical education and the growing requirements of robotic-assisted procedures.

Prediction

By 2030, robotic-assisted procedures could comprise over 20% of all surgeries in Indian metros and at least 5–10% in smaller cities.

Top Hospitals and Surgeons Leading the Way

Pioneers

Dr. Arvind Kumar: Known as the "father of robotic thoracic surgery" in India; pioneered robotic chest surgery at AIIMS, now leading at Medanta.

Dr. Mahendra Bhandari: Global leader in robotic urology and CEO of the Vattikuti Foundation.

Key Centers

According to TechSci Research “India Surgical Robotics Market By Application (Orthopedics, Neurology, Urology, Gynecology, Others), By End Use (Inpatient, Outpatient), By Region, Competition, Forecast & Opportunities, 2020-2030F,” India Surgical Robotics Market was valued at USD 24.72 million in 2024 and is expected to reach USD 44.91 million by 2030 with a CAGR of 10.42% during the forecast period. The market growth is driven by various factors, such as government initiatives and policy support, advancements in robotic technology, etc.

Several Factors Driving the Growth of India Surgical Robotics Market:

• Government Initiatives and Policy Support
  India's government has launched several programs to bolster the healthcare sector's technological capabilities. Programs like Make in India and Atmanirbhar Bharat promote the local production of medical devices, including surgical robots. The Production Linked Incentive (PLI) scheme further incentivizes local production, reducing reliance on imports and making advanced surgical equipment more accessible.
• Advancements in Robotic Technology
  Technological innovations have significantly enhanced the capabilities of surgical robots. Integrating artificial intelligence (AI), machine learning, and augmented reality has improved surgical precision and efficiency. These advancements enable real-time data analysis, predictive analytics, and personalized treatment plans, contributing to better patient outcomes and shorter recovery times.
• Economic Accessibility and Indigenous Innovation
  The introduction of cost-effective, domestically developed robotic systems, such as the SSI Mantra, has made robotic surgery more affordable. Priced significantly lower than imported alternatives, these systems have expanded access to advanced surgical procedures across various healthcare facilities.
• Rising Prevalence of Chronic Diseases
  An aging population and increasing incidence of chronic diseases like diabetes, hypertension, and cancer have escalated the demand for advanced surgical interventions. Robotic-assisted surgeries offer precision and minimally invasive options, addressing the complexities associated with treating such conditions.
• Expansion of Medical Tourism
  India's competitive pricing and high-quality healthcare services have made it a preferred destination for medical tourism. The availability of robotic-assisted surgeries at a fraction of the cost compared to Western countries attracts international patients seeking advanced treatments.

Conclusion:

Surgical robotics in India is not just a technological milestone; it’s a paradigm shift in how healthcare is delivered. While challenges remain, India’s innovation ecosystem, skilled medical professionals, and growing patient demand are propelling the country into a new era of surgical excellence. With the right investments in training, affordability, and public awareness, robotic surgery will no longer be the privilege of a few—it will be the standard of care for many.