“The first robotic surgery patient of the Philippine General Hospital was a jeepney driver with prostate cancer; and this initial operation set the PGH Robotic Surgery (RS) program in the right direction,” according to PGH Director Gerardo Legaspi.

Steering the PGH to greater heights in healthcare delivery for seven years now, Dr. Gap as he is fondly called, has always believed that technology is a tool that can reduce the disparity between the rich and the poor in accessing healthcare services. RS is one cutting-edge technology that has made PGH a game changer in patient care since the device was acquired on March 5, 2019.

Robotic surgery is a surgical procedure that involves robotic devices through vortex systems and which allows surgeons to perform better complex surgeries with more precision than their open operations. In robotic surgery, it is still the human surgeon who operates on the patient with the help of the robotic device.

During the Stop C.O.V.I.D Deaths Webinar #149, “Robotic Surgery: The Future in the Palm of our Hands” held on June 9, RS experts shared insights and clinical outcomes of robotic-assisted procedures and discussed subspecialties where RS has made significant strides.

Benefits of RS

Main presenter Dr. Nikko Magsanoc, head of the PGH Robotic Surgery Program, stated that “we can do almost anything in RS and its benefits are all documented: precision; reduced blood loss, pain, infection, nerve damage, and hospital stay; improved outcomes, less scarring, and faster recovery; and improved access to surgery.”

“We can do exactly the same things we do in open surgery. We can cut, burn, see, and do everything which simulate open surgery. It’s so precise that we can even peel a grape for that matter. We can take out the prostate, do a hysterectomy, dig up the gallbladder, take out the kidney, fix the mitral valve, do colorectal surgery and bariatric surgery. We can take out the thyroid, the adrenal gland, the lungs; or perform any thoracic surgery,” Dr. Magsanoc asserted.

Meanwhile, Dr. Dennis Serrano, former division chief of PGH Division of Urology and Transplant Surgery, stated that RS is now a standard of care for prostate procedures. He was joined by Dr. Hermogenes Monroy III, Quality and Safety Committee head of PGH Department of Surgery, in sharing experiences and clinical outcomes in the robotic approach in rectal cancer surgery; and Dr. Sylvia Karina Ali, PGH Robotics Surgery coordinator, who shared the current capacity and future vision and who attested to the non-inferiority of RS.

Dr. Magsanoc acknowledged that worldwide, robotic surgeries have been increasing since 2016 at 3,000 plus. In Asia, he counted 689 surgeries adding that in Southeast Asia, Thailand has the most number at about thirteen while the Philippines has only four. The PGH is the first government hospital to do RS.

He still holds dear in his heart what Dr. Gap told him, “Just because the Philippines is classified as a developing country does not mean its citizens should be limited to developing Third World medical options. We should offer top tier healthcare for all individuals irrespective of social economic status. I think we have to offer high quality health care because it is a universal right.”

In private hospitals with RS, Dr. Magsanoc said that one can spend an average of 500, 000 to 1 million pesos for surgery. “But in our PGH charity service, patients practically spend nothing. I remember when Dr. Legaspi said that we want to give the jeepney driver the same operation that the tycoon would get in St Luke’s Medical Center or any other private hospital.”

He bared that PGH is second in the country next to Saint Luke’s in number of cases and it is well on its way to reaching its target. As of 2020, the hospital already did 228 cases, a mixture of both gynecologic, urologic, thoracic, and otorhinolaryngology cases.

He confirmed that four surgeons were initially trained and that more were further trained including female surgeons, neurologists, gynecologists, and general surgeons. The increased investment on training is geared towards increased utilization. Nurses are also being trained “because they are part of the equation.”

Research forms a major component of the RS program and Dr. Magsanoc stated that there’s a lot of research in the pipeline. According to him, the life of the robot is just a few years so they have to be smart with their resources.

“In the end, we actually did it; we were able to start the program, we are on track, and we are hitting our targets. Just like PGH when it was war-torn, we were warriors. From the ashes, we eventually emerged to what it is now—stronger! This program is part of our desire to make PGH not the last resort, but the first option when having surgery in the country.”

I Cynthia M. Villamor