Introducing SSI's Mantra

Meet SSI Mantra, a low-cost indigenously developed robotic surgery platform:

 "This is a state-of-the-art system, with no corners being just because it is a 'low-cost' initiative. Instead of going along the lines of already established robotic surgery systems, Mantra has been designed from scratch, with local conditions and needs in mind, which makes it suitable for any advanced medical facility in the world at the same time. Instead of all the surgical arms emerging from one monolithic post, each of the arms have their own mast, which is mounted on a cart, which the team refers to as "scooters". This is because they can be manoeuvred around much like two wheelers, with a throttle, clutch and brake. Having independent arms allows for a versatile, modular system with between three and five arms, that can be individually set up according to the requirements of the procedure.

There are two monitors for the doctor, a 3D one where the doctor can see a magnified view of the surgery, and a touchscreen control panel. There is another 3D monitor for the other healthcare workers in the operating theatre as well. On top of the primary monitor is a row of cameras, which is a safety feature that makes sure that the arms stop moving when the doctor is not looking directly at the screen. For the safety feature, SS Innovations tried using eye tracking, but that was not very accurate, so they opted for head tracking instead.

What makes Mantra even more impressive is that it was developed in under three years, which would have been further accelerated if it were not for delays caused by the pandemic. However, the techniques developed for the novel procedures extend beyond the development of the robot itself. To understand more about the development of Mantra, we spoke to Sudhir P Srivastava, CEO and founder of SS Innovations, in an office right next to the room where the surgical robot was housed.

The founder, Dr. Srivastava had to switch out his doctors hat for the founders, "We started to develop, and I literally ran out of money. I was not practicing because I was completely focused on development. I sold my car, sold my furniture, borrowed money from friends to support the team, while trying to raise money. I went to the government also, the Make In India initiative had started, but there was no infrastructure set up to even support the scheme. Finally, we got overseas funding in 2017. We developed the system which we are not calling Mantra. I wanted a Sanskrit name. We literally moved very fast, with a relatively small amount of money. By 2019, we had raised almost 33 million dollars. Our team also grew. Initially we had our facility in Andhra Pradesh Medtech Zone in Vishakhapatnam, which was under Modiji's Make in India initiative. We did the first clinical trial in India, at the Rajiv Gandhi Cancer Institute. It was a very complex operation with our first generation Mantra. It went very well, and was very successful. The patient did very well and there was no device related issue.

After that came the process of product iterations, clinical trials, and regulatory clearances required for any medical device. "At that point, we observed certain things in the system, we do the trials mainly to see how it will function with the live patients, so that is generally never the final product. So we made certain modifications and we created the second generation Mantra very rapidly, we made all the changes. Now, Mantra 2 is absolutely ready, and we are going to be going for a short animal and a clinical trial. Basically, it is market ready. Various very prominent surgeons have tested out the system, and all of them, without exception have said that the system is ready for clinical use and going to the market. Currently we have ISO 13485 certification, which is an international certificate, given by a third party, required for medical devices. We are also registered with Central Drugs Standard Control Organisation (CDSCO)." CDSCO is the national regulatory body for cosmetics, pharmaceuticals and medical devices. The Mantra system is on the verge of hitting the market. Srivastava says, "We have tremendous interest among doctors and hospitals. My vision was always that in terms of quality and performance, the Mantra system should be very similar to the da Vinci surgical system. Not only have we achieved that, but we have better features and more uses. Including da Vinci, no one is doing cardiac surgeries. There is a huge volume of cardiac surgery patients, not only adults, but children also. Almost 99 per cent of these have their sternums split, leading to long recoveries and complications. We have added the cardiac specialty with our system, and no one in the world has this ability at the level we are offering. Our Mantra system is designed to address all specialties, general surgery, neurology, gynecology, thoracic, at the neck, and cardiac on top of all these things.""

Source: News Nine