reconsider their brands, revaluate what they offer patients, and
develop new skills to enhance
their standing. Like their patients,
they too have seen the value of
minimally-invasive surgery. Even
experienced surgeons with a long
track record of performance are
altering their practices to reflect the
changing times. This is something
equipment providers are trying to
influence through education and
training, as well as bringing in doctors from developed markets to
create workshops and other informational sessions.
“You can educate and make them
aware that the procedure types are
different, but the outcome is much
more powerful and successful,”
Chalke says. “Once you demonstrate that, and let them manage some of
these practices in cadaver labs, they build their own confidence and trust in
moving from open procedures to MIS procedures,” he says. “A few things
you look at are what the doctor is doing today and how he is looking at
his own brand. If you start working on both, we do see adoption and
Not that there isn’t a significant hurdle standing in the way of con-
tinued growth of this trend: infrastructure. The issue is whether or not
it will support the implementation of expensive, but necessary, medical
equipment. Support and advice from equipment suppliers or medical
device companies on issues such as power supply, accessories, training,
and technical support is crucial to ensure successful implementation.
According to Chalke, they need to partner with facilities and try to cre-
ate a solution for them versus just providing a product.
“It has to be bundled together, so as not to have them be forced to
make their own decisions,” he says.
For example, some physicians from small or less developed markets
have traveled to bigger ones to shadow physicians at big hospitals for
added training. Sometimes six to seven months of training is needed to
help physicians and surgeons learn how to do a procedure. This allows
them take the requisite knowledge back to their home countries and
help them ensure a strong future success rate.
Then the question becomes what is the return on investment of
equipment necessary for MIS procedures. In some cases, they can be
leased over time with the equipment being returned if the efforts to
adopt MIS in certain emerging markets are not successful.
“It is not enough to be an equipment supplier in these emerging mar-
kets," says Chalke. "You have toprovide complete solutions from operat-
ing the system to maintaining the system to ensure things work.”
The increased prevalence of MIS surgery in emerging markets is
driven by the procedures, not the technology. The technology is being
developed to help make the surgeons’ jobs easier. Products are also
being designed and manufactured in some of these emerging markets.
Access to more patients will drive this trend, as will improved infrastruc-
ture and growing economies in these developing markets
“Also, new physicians being trained are being trained on MIS, and that
certainly is driving the acceptability, the adoption and the actual implemen-
tation of MIS in these countries,” Chalke says.
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