Surgical Robotics and Remote Surgery in Low- and Middle-Income Countries: A Systematic Review with Strategic Implications for Pakistan

Abstract

Surgical robotics are used to perform remote surgery, which is a radical solution to overcoming surgical inequities in resource-poor countries. The given systematic review focuses on the current state, issues, and perspectives of robotic-assisted remote surgery and pays special attention to Pakistan as a representative of low- to middle-income countries (LMIC). In the detailed review of the available literature, the following barriers are distinguished: high costs, infrastructure constraints, and the lack of training, and the opportunities include enhanced access to specialist care and lower healthcare inequalities. The review brings together 45 studies and shows that robotic systems are slowly but steadily implemented in Pakistan since 2011, and more than 700 procedures were carried out till today. Results highlight possibilities of telesurgery to narrow down geographical distances, yet it requires strategic investments, policy changes, and bilateral partnerships. Some of the recommendations provided include the creation of affordable robots platforms, the improvement of national digital infrastructure and the creation of national training programs. This paper presents a road map on how robotic remote surgery can be incorporated in the Pakistan healthcare system, in the end evolving to improve surgical services in the underserved areas.

Keywords: Surgical Robotics, Remote Surgery, Telesurgery, Low-Resource Settings, Pakistan, Healthcare Disparities.