India’s leading surgical associations urge streamlined insurance implementation for robotic-assisted surgery to ensure equitable access

• Robotic-assisted surgery offers significant health benefits, but gaps in insurance implementation continue to place the burden of affordability on patients.

• Collaboration among healthcare providers, insurers, and policymakers is crucial to making robotic-assisted surgery (RAS) more accessible to a wider population.

Recognising the regulatory shift brought about by the IRDAI’s 2024 directive mandating coverage for robotic-assisted surgeries, key surgeon associations in India have stressed the need for uniform implementation across health insurance providers to ensure consistent patient access.

“The healthcare industry in India has seen remarkable progress in recent years, and robotic technology has been central to this transformation in surgical care—not only by improving clinical outcomes but also by enhancing the overall patient experience during and after surgery,” said Dr. Vivek Bindal, Chairman, Clinical Robotic Surgery Association (India Chapter). “Both emerging clinical evidence and real-world surgical experience indicate that robotic-assisted surgery is associated with lower recurrence rates, reduced need for blood transfusions, and a measurable decline in mortality.”

With robotic-assisted surgery (RAS) now included under mandated health insurance coverage, many private insurers are gradually aligning with the directive. However, inconsistencies in claim approvals, sub-limits, and coverage caps across providers still hinder patient access.

“As robotic-assisted surgery increasingly becomes standard in both public and private hospitals, it is important for insurance coverage and implementation to keep pace with clinical practice. The IRDAI mandate marked a pivotal shift in acknowledging the clinical value of robotic surgery. What we now need is consistent coverage inclusion in policy and implementation across providers and insurers alike,” Dr. Bindal added.

Emphasising the need for robotic technology for women facing gynaecological health issues, Dr. Rooma Sinha, Founder President, Association of Gynaecological Robotic Surgeons, India, said, “No woman suffering from gynaecological conditions should undergo open surgery when minimally invasive techniques, such as robotic-assisted surgery, are available. Patients undergoing robotic-assisted surgery benefit right from the start, with minimal tissue trauma and reduced damage to surrounding organs during the procedure—resulting in smoother recovery, less pain, and a lower risk of infection.  Insurance companies should also consider that robotic-assisted surgery should not be viewed simply as an alternative to laparoscopic surgery, nor should the two be considered equivalent.”

Dr. Sinha pointed out that robotic-assisted surgery offers superior dexterity and high-definition visualisation, making it particularly valuable in gynaecological cases where minimising complications is critical. “In a recent multi-institutional study on gynaecological robotic surgery in India, which I was a part of, we observed that issues—like port-site discomfort or minimal bleeding—occurred in less than 2% of cases, while serious complications such as bowel injury or vessel damage remained below 1%,” she said.

Even with mandated insurance coverage in place, robotic-assisted surgery often encounters uneven implementation on the ground. This disconnect has shifted the financial burden onto patients, who are frequently forced to weigh the clinical benefits of RAS against the risk of high out-of-pocket expenses. Nevertheless, clinicians continue to see growing demand for robotic procedures, driven by greater awareness and patient preference. “Despite knowing that the insurance might not cover the expense, a lot of patients choose robotic-assisted surgery over traditional laparoscopic or open surgery, even for benign conditions considering the benefits the surgical procedure offers. This reflects the high satisfaction and positive outcomes that patients experience with the robotic approach,” said Dr. Randeep Wadhawan, President, Obesity and Metabolic Surgery Society of India.

These experts conclude that for robotic-assisted surgery to become a meaningful part of mainstream care, insurance frameworks must evolve to reflect current clinical realities. Rather than treating RAS as an optional upgrade, payers need to assess its role in improving long-term outcomes and reducing downstream costs. Ensuring consistent and evidence-based insurance support for robotic-assisted surgery is essential to making advanced surgical care more equitable and sustainable within India’s evolving healthcare system. “Collaboration among healthcare providers, insurers, and policymakers is crucial to making robotic-assisted surgery more accessible to a wider population,” Dr. Wadhawan added.

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