CHALLENGES IN ACCESS TO ROBOTIC SURGERY IN RIO GRANDE DO SUL

Introduction With technological advancements, robotic surgery has gained prominence in the treatment of colorectal cancer. However, Brazil still has limited robotic platforms. The geographic distribution of people and these technologies creates inequalities in access to medical care.

Objective To analyze the distribution of robotic surgery centers in Rio Grande do Sul (RS) and estimate the number of patients without access to this service.

Method Data from the DataSUS Oncology Panel was used to gather information on the number of patients diagnosed with colorectal cancer (ICD C18 to C21) in each municipality of RS and how many underwent surgical treatment. Municipal sociodemographic data were obtained from IBGE. Geospatial analysis was performed using ArcGIS Online software, considering a 2-hour driving limit to robotic surgery centers.

Results In RS, there are seven hospitals with robotic platforms: three in Porto Alegre, one in Santa Maria, one in Caxias do Sul, one in Novo Hamburgo, and one in Passo Fundo. Approximately 134 (26.85%) municipalities in RS fall within the 2-hour travel zone to a robotic surgery center, covering around 6,610,119 (60.75%) of the state’s population. In 2023, 5,488 patients were diagnosed with colorectal cancer via the SUS, with 1,118 undergoing surgical treatment. Considering two access scenarios for robotic surgery, 2,111 (38.47%) of the patients diagnosed with colorectal cancer and 383 (34.26%) of those treated surgically are located more than 2 hours away from a robotic surgery center. Geographical analysis revealed that most municipalities with the highest prevalence of colorectal cancer are within the 2-hour travel zone, but there is a lack of access in the southwestern part of the state. Sociodemographic data showed an average schooling rate of 87.18% for children aged 6 to 14 years, a mean human development index of 0.62, and a per capita GDP of R$51,558.60 outside the 2-hour travel zone, compared to 78.45%, 0.59, and R$52,624.12, respectively, within the travel zone. Only schooling showed a significant difference (p = 0.0009).

Conclusion Most of the population and colorectal cancer patients are near cities with robotic surgery centers, but a significant portion remains underserved. The state data only accounts for the SUS network, while current robotic surgery users are predominantly private healthcare patients.

No conflict of interest has been declared by the author(s).

Publication History

Article published online:
25 April 2025