This article has been published in partnership with Kalaari Capital.

Dr Sunil Kumar Venkatappa hears the same question almost every day. After the diagnosis and the surgery date, patients invariably ask, "How soon can I get back to work?" Seeing nearly a hundred patients each week, he knows that successful surgery is only part of the journey; an equally important part is helping patients understand what recovery and life after the surgery will look like and reassuring them that returning to their lives as quickly and safely as possible is within reach. 

“Especially when a patient is the sole breadwinner, they're often reluctant to get admitted. Even if they're in significant pain, they're thinking about the income their family depends on. Every day away from work affects their livelihood,” says Dr Venkatappa, Assistant Professor of General Surgery at Bangalore Medical College and Research Institute, who also performs minimally invasive and bariatric surgery at Victoria Hospital, Bengaluru. Patients often weigh the outcome of a much-needed surgery against the source of livelihood they stand to lose. More often than doctors would like, the source wins.

Done the old way, these operations could once have meant a week or more in hospital. And the patient has to live with a large abdominal scar to constantly remind them of this ordeal "Now, though I  perform bariatric surgery, which is quite complex... only one or two days is now the current standard," he says, “And the fact that these surgeries are now becoming virtually scarless is a strong add-on”

He reassures his patients that they will likely get safely discharged the next morning. Some do not believe him. "For them, one-day discharge and getting back to their lives in weeks instead of months, a surgery with no scars and low postoperative pain, is magic."

That disbelief says less about medicine than about how rarely most Indian patients get to experience this kind of recovery.

Why robotic surgery remains out of reach for most Indians

Nearly 70 percent of surgeries in India are still performed as open procedures, involving larger incisions, longer recovery periods, and more time away from work and family. Robotic surgery, which can significantly reduce recovery time and improve the patient’s quality of life in complex procedures, accounts for less than 1 percent of surgeries nationwide. Of India's roughly 70,000 hospitals, fewer than 300 have an active surgical robotic system, and only around 2,000 surgeons in the country have been trained to use one.

Cost is one of the biggest reasons. Existing robotic surgical systems can cost Rs 12–20 crore, along with significant annual maintenance and consumable costs that run into lakhs per surgery, making them inaccessible to most hospitals. The technology also requires specialised infrastructure, with many systems requiring operating theatres designed around them.

While cost and infrastructure are major problems, it is not the only one plaguing the surgical ecosystem in the country. Surgeons operating with the help of Surgical robots require extensive hands-on training. This training currently remains heavily gatekept through proprietary simulators tied to specific manufacturers. This means surgeons only get trained after their hospital purchases a specific........

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