J Minim Invasive Surg.  2024 Sep;27(3):142-155. 10.7602/jmis.2024.27.3.142.

Analyzing the emergence of surgical robotics in Africa: a scoping review of pioneering procedures, platforms utilized, and outcome meta-analysis

Affiliations
  • 1General Surgery Community, Surgery Interest Group of Africa, Lagos, Nigeria
  • 2Department of Medicine and Surgery, College of Medicine, University of Ibadan, Ibadan, Nigeria
  • 3Department of General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
  • 4Significant Polyp and Early Colorectal Cancer (SPECC) Service, King’s College Hospital, London, United Kingdom
  • 5Department of Surgery, Afe Babalola University, Ado-Ekiti, Nigeria
  • 6Department of Surgery, University of Ilorin Teaching Hospital, Nigeria
  • 7Department of Medicine and Surgery, College of Medicine, University of Port Harcourt, Choba, Nigeria
  • 8Department of Surgery, Gaston Berger University, Saint-Louis, Senegal

Abstract

Purpose
Surgical practice globally has undergone significant advancements with the advent of robotic systems. In Africa, a similar trend is emerging with the introduction of robots into various surgical specialties in certain countries. The need to review the robotic procedures performed, platforms utilized, and analyze outcomes such as conversion, morbidity, and mortality associated with robotic surgery in Africa, necessitated this study. This is the first study examining the status and outcomes of robotic surgery in Africa.
Methods
A thorough scoping search was performed in PubMed, Google Scholar, Web of Science, and African Journals Online. Of the 1,266 studies identified, 16 studies across 3 countries met the inclusion criteria. A meta-analysis conducted using R statistical software estimated the pooled prevalences with the 95% confidence interval (CI) of conversion, morbidity, and mortality.
Results
Surgical robots are reportedly in use in South Africa, Egypt, and Tunisia. Across four specialties, 1,328 procedures were performed using da Vinci (Intuitive Surgical), Versius (CMR Surgical), and Senhance (Asensus Surgical) surgical robotic platforms. Urological procedures (90.1%) were the major procedures performed, with robotic prostatectomy (49.3%) being the most common procedure. The pooled rate of conversion and prevalence of morbidity from the meta-analysis was 0.21% (95% CI, 0%–0.54%) and 21.15% (95% CI, 7.45%–34.85%), respectively. There was no reported case of mortality.
Conclusion
The outcomes highlight successful implementation and the potential for wider adoption. Based on our findings, we advocate for multidisciplinary and multinational collaboration, investment in surgical training programs, and policy initiatives aimed at addressing barriers to the widespread adoption of robotic surgery in Africa.

Keyword

Robotic surgical procedures; Minimally invasive surgical procedures; Africa
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