Obstetrics & GynaecologyDr. Alka DahiyaRobotic Gynaecologic Oncology

Senior Consultant, Gynaecological Surgical Oncology, BLK-Max Super Speciality Hospital, New Delhi

Part 10 of 12 in Role of Minimally Invasive Surgeries in Gynaecologic Oncology

What Robotic Surgery Still Costs, in Money and in Time

August 27, 2026

Robotic surgery is, in Dr. Alka Dahiya's own description, a relatively newer technology than laparoscopy or open surgery, and it comes with limitations she is candid about rather than glossing over.

The cost barrier

Robotic surgeries are still not covered by many insurance companies or government panels in India, which keeps per-procedure rates high. For a case such as robotic hysterectomy for endometriosis, the cost in Indian currency runs to roughly 4 to 5 lakhs, or approximately 4,000 to 5,000 US dollars, depending on the exact procedure performed. Dr. Dahiya expects costs to come down over time as adoption widens.

Operative duration and the training gap

Docking, undocking and setup add to operative time compared with conventional approaches. Training also needs to expand significantly: as more surgeons train and case volumes rise, Dr. Dahiya expects both rates and expertise to improve in step.

The stakes are higher in oncology

The limitation Dr. Dahiya returns to most is patient selection in cancer cases. An inadvertent injury, inadvertent spillage, or a wrong call on operability in cervical or ovarian cancer can seriously harm the patient and create real medico-legal exposure for the surgeon. Careful selection of surgical candidates, in her framing, is not a best practice but a precondition for using the technology at all.

This guide is based on a live Jivo Masterclass — Dr. Alka Dahiya taught doctors across Africa on March 29, 2026.

FROM THE LIVE Q&A

DR

Dr. Samuel Amaize

Is it possible to visit your centre for training, or to join a fellowship there?

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Dr. Alka Dahiya

Yes. BLK-Max takes two robotic fellows every year, one in surgical oncology and one specifically in gynaecologic oncology, each for a one-year fellowship in minimally invasive robotic surgical oncology. The full application procedure and selection criteria would be shared afterward through the Jivo Healthcare team.

See all 4 questions from this masterclass →

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Frequently Asked Questions

What is the average cost of a robotic surgery, for example a robotic hysterectomy for endometriosis?

Cost depends on the exact procedure. For endometriosis surgery, whether it involves removing the uterus or only a cystectomy changes the figure, but in Indian currency the cost is typically 4 to 5 lakhs, roughly 4,000 to 5,000 US dollars.

For someone coming from a general medicine background in gynaecology rather than a surgical one, what is the process for training in robotic surgery in India?

A basic surgical background is required. Admission into a robotic training course in India requires an MS in Obstetrics & Gynaecology or MS in General Surgery, with at minimum some exposure to procedures such as LSCS, so the surgeon understands the underlying operative anatomy and principles. Without that foundation, the transition is very difficult. Requirements vary by country, and it would be worth checking what pathways exist locally.

How long does it take to train to become competent in robotic surgery, what does that training cost, and is it necessary to train in laparoscopy first?

It is definitely possible to train in robotics directly, and many surgeons find it easier to learn than laparoscopic surgery, especially if they are already comfortable with open surgery. India has a three-step pathway supported by Intuitive: Level 1 is simulation-based certification, Level 2 requires 30 to 50 procedures completed independently or under supervision, and Level 3 is advanced training. There is no requirement to learn laparoscopy first, though prior exposure helps. Most surgeons gain confidence within a year of focused training, with a trained bedside assistant supporting the docking and undocking process.

Is it possible to visit your centre for training, or to join a fellowship there?

Yes. BLK-Max takes two robotic fellows every year, one in surgical oncology and one specifically in gynaecologic oncology, each for a one-year fellowship in minimally invasive robotic surgical oncology. The full application procedure and selection criteria would be shared afterward through the Jivo Healthcare team.

Why isn't robotic surgery covered by insurance?

Robotic surgeries are still not covered by many insurance companies or government panels, which keeps per-procedure rates high. Costs are expected to come down over time as adoption widens.

Why does robotic surgery take longer in the operating room than other approaches?

Docking, undocking and setup add to operative time compared with conventional laparoscopic or open approaches.

What is the biggest risk factor when using robotic surgery for cancer cases?

Patient selection is the limitation returned to most often. An inadvertent injury, inadvertent spillage, or a wrong call on operability in cervical or ovarian cancer can seriously harm the patient and create real medico-legal exposure for the surgeon.

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