Robotic Surgery in Guyana: First Report From the Caribbean.

Although robotic surgery is widely accepted as the gold standard approach for a variety of operative procedures, the Caribbean region lacked access to surgical robotics until recently. The surgical fraternity in Guyana recognized the need for progress to robotic surgery. Herein, we report the first robotic surgery procedure performed in Guyana and highlight the obstacles and challenges faced, and the success achieved while introducing the technology in a low-resource setting. Using the SSI Mantra 3 Robotic Surgical System (SS Innovations International Inc., Haryana, India), a multidisciplinary team carried out a procedure on a 34-year-old man with a right inguinal hernia. From the surgical command centre, the lead surgeon dissected a preperitoneal space to reduce the sac and reinforce the inguinal canal with a lightweight polypropylene mesh. The peritoneum was closed to complete a robotic trans-abdominal pre-peritoneal (TAPP) repair. To our knowledge, this was the first robotic TAPP procedure recorded in the English-speaking Caribbean. With the support of administrators and buy-in from surgical leaders, the surgical fraternity in Guyana has seized a broader vision to modernize healthcare services, providing advanced surgical care in the Caribbean region. We demonstrated that robotic surgery is feasible and safe in the Caribbean environment, provided there is appropriate training, proctorship, and selection of robotic platforms. This report should encourage other countries in the Caribbean region to transition to robotic surgery. In our experience, the success of our programme depended on four pillars: (1) strong leadership support, (2) buy-in from the surgical community, (3) involving all specialties to maximize case volumes, and (4) selection of an affordable and effective platform.