Advanced Technology In The Operation Theatres Of Developing Countries- Economic Justification

Abstract

Technological advancement in the field of operative neurosurgery has been quite rapid, and it has shown to improve the clinical outcome. However, this incurs a heavy financial burden and makes the treatment costly and out of reach for the majority of patients in developing countries, where expertise is not lacking but newer gadgets are. The financial burden needs to be justified by health institutions. For a modern neurosurgical operation theatre, an operating microscope, endoscope, and high speed drills are essential tools for cranial procedures. CUSA , electrophysiological monitoring, frame-based and frameless stereotaxy are becoming essential in higher centres. Intraoperative MRI, ultrasound, and LASER are required in more advanced neurosurgical setups.

For spine surgery, a C-ARM, high-speed drill, operating microscope, and electrophysiological monitoring are essential tools. 3D neuronavigation tools such as O-ARM or intraoperative CT are required for better outcomes, especially in cases of complex spinal instrumentation. All high volume neurosurgery centres should strive for this. A slight modification in intraoperative planning can make sure that MRI is used by routine patients in spare time to make it economically feasible. Minimally invasive spine surgery is the new gold standard. O arm or intraoperative CT navigation uses can reduce radiation to the surgeon.

To make it cost-effective, Its uses can be increased by checking shunt positioning and electrode placements in functional neurosurgery. A routine ultrasound used by anaesthetists can be used for spinal tumour localisation, brain tumour, or ventricle localization. Robotic-assisted cranial surgery and spinal robotic-assisted surgery for pedicle screw placement, biopsy, kyphoplasty and planning complex vertebral resection are here to stay because of its safety, accuracy and demand by the patients and virtually eliminated radiation to surgeons. Cost effectiveness can be increased by increasing its uses and thus decreasing cost per patient.

In conclusion, it is possible to acquire these important advancements with careful planning, its increased use and sharing them with other departments where these gadgets can be used.