Cost-Effectiveness of Minimally Invasive Surgery in Outpatient Settings

In an exclusive interaction with India Pharma Outlook, Nitin Stephen Abel, Senior Director, Terumo Interventional Systems, Terumo India, discusses how India’s shift toward outpatient surgeries is driving medical device manufacturers to reengineer minimally invasive technologies to be more portable, cost-effective, and intuitive—backed by solution-based partnerships, skill transfer, and scalable innovations like AI platforms and disposable kits. Nitin Stephen Abel is a strategic growth leader in medical devices and diagnostics, with over two decades of cross-functional expertise across India, Asia-Pacific, and MEA. He excels in business transformation, people development, and navigating complex healthcare ecosystems.

As the outpatient surgeries are rising across India, how are medical device manufacturers adapting MIS technologies to meet cost, portability, and usability demands in these settings?

It might not come as a surprise that India’s healthcare landscape is undergoing a quiet transformation. Procedures once confined to large hospitals like angioplasties, endoscopic procedures and even certain oncology interventions are increasingly being performed in outpatient and day-care settings. Patients want quicker recoveries; providers want to optimize time, space, and resources. The move toward outpatient care isn’t just a trend; it is perhaps the future. India's outpatient surgery market is expected to almost double by 2030, reaching a value of $3.48 billion. This expansion is driving manufacturers to develop scalable, accessible, and efficient solutions that cater to the changing requirements of both patients and healthcare providers.

This shift is pushing medical device manufacturers to think differently. Adapting hospital-grade equipment for smaller centers is no longer enough. There is now a need for systems that are light, modular, intuitive, and mobile. We’re seeing a strong focus on plug-and-play platforms that require minimal infrastructure, such as compact cathlab setups, streamlined imaging tools, and versatile access devices. These technologies are being designed for speed and simplicity, without compromising on precision.

What’s exciting is how this intersects empathy with engineering. Devices like the Progreat Lambda, for instance, are gaining traction in outpatient centers because they’re easy to handle, reduce dependence on ancillary tools, and are suited to multiple interventions. This isn’t just innovation, it’s adaptation with intent.

High equipment costs often limit adoption. What pricing or leasing models are device makers offering outpatient centers to improve access to minimally invasive technologies?

That’s one of the biggest challenges we’re seeing on the ground. The upfront cost of MIS equipment, whether it’s high CapEx on imaging platforms, robotic arms, or specialized catheters can be a real barrier, especially for standalone day-care centers or tier-2 hospitals.

To navigate this, medtech firms are moving from “product selling” to “solution partnerships.” Leasing models, pay-per-use arrangements, and hybrid packages (equipment bundled with training, maintenance, and digital services) are now increasingly common.

At Terumo India, for instance, we’ve introduced models where we co-create capex pathways, sharing the upfront cost burden and ensuring utilization support via training modules and data insights. This ensures financial viability for the hospital and sustained access for the patient, a win-win model.

We’re also watching a global shift toward subscription-based platforms for AI-assisted MIS platforms. Think of it as “MIS-as-a-service,” much like how cloud computing revolutionized access in tech. In India, we’re just scratching the surface.

Compact and multifunctional devices are viewed as critical in outpatient care, how are manufacturers balancing precision and cost-effectiveness in the design of minimally invasive surgical tools?

Manufacturers are becoming increasingly innovative in balancing precision with cost-effectiveness for minimally invasive surgical instruments, particularly as outpatient care requires smaller footprints and quicker turnover. That's where minimalist engineering meets innovation. The new standard is "precision without complexity." Devices like our Finecross MG microcatheters or Occlusafe balloon occlusion systems are designed not only to perform highly specialized tasks, say like embolization or TACE but it also ensure versatile use across multiple anatomies or procedures, which enhances their cost-effectiveness.

The manufacturer are utilizing multifunctional tool integration where devices are being designed to combine multiple functions into single instrument which reduces the number of tool exchanges during surgery saving time and cost while improving precision.

The materials matter too; high-durability polymers and braided constructions allow for multiple-use durability without compromising performance, lowering the cost per procedure. Compact doesn’t mean compromised, it means consolidated functionality. Instead of five separate tools, the market is moving towards a single smart tool that does the job of all five.

Moreover, advancements like hydrophilic coatings and ergonomic handle designs also reduce the learning curve and improve surgeon confidence, even in high-volume outpatient scenarios.

Surgeon training influences device efficiency. What role are medtech companies playing in enabling skill transfer for optimal device usage in outpatient surgical environments?

One of the biggest myths about minimally invasive surgery is that the outcomes depend solely on the sophistication of the device. In reality, even the most advanced tools are only as effective as the hands that use them. And in the context of India’s fast-growing outpatient and tier 2–3 healthcare landscape, this becomes even more critical.

Medtech companies are making significant strides to ensure that surgeons are not only trained but also empowered to optimally utilize devices in outpatient surgical environments. This is being achieved through various methods, including immersive training platforms and training labs.

Skill transfer today isn’t a one-time activity; it’s an ongoing journey. The real differentiator is how consistently and confidently clinicians can apply these tools in real-world settings. This is where medtech companies must evolve from merely being vendors to becoming true training partners.

At Terumo India, this thinking has shaped the foundation of the Terumo India Skill Lab (TISL). Through simulation-based training platforms like the Mentice simulator beating heart models, vascular flow setups and even investing now in a fully operational cathlab, clinicians get to practice complex procedures in a risk-free environment before ever stepping into the OR.

We’re also scaling this effort through live case support, digital modules, and peer mentorship, especially in cities where access to structured training is limited. Because in the end, the most powerful innovation isn’t the device; it’s what happens when skilled hands and smart tools come together with purpose.

AI-assisted MIS platforms and disposable kits are emerging. How might these shape the cost structure and scalability of outpatient surgery solutions over the next five years?

As India’s healthcare ecosystem expands beyond metros, the real question isn’t just how we innovate, but how we scale that innovation meaningfully. Outpatient MIS is growing rapidly, but to truly serve patients across diverse geographies, we need solutions that are not only advanced but also replicable, intuitive, and resource conscious.

This is where AI and disposable kits are emerging as game-changers. AI-assisted platforms, especially those integrated with imaging and navigation systems, are making procedures more precise and less dependent on large surgical teams. Early trials show that real-time anatomical mapping and guided decision-making can reduce procedure time by up to 30%, which has huge implications for high-volume centers and newer surgeons alike.

Meanwhile, procedure-specific disposable kits are helping outpatient facilities overcome infrastructure gaps. By reducing setup time, bypassing sterilization cycles, and minimizing infection risks, they are making MIS safer and more accessible, especially in semi-urban and rural settings where reliability is non-negotiable.

Together, AI and disposables are rewriting what scalability looks like, not just for advanced hospitals, but for every care center that wants to deliver high-quality, minimally invasive treatment quickly and safely, at scale.