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The Value of Surgical Robotics: Can We Afford It?

ValueConnected

In 1985, a group of neurosurgeons placed a biopsy needle in the brain of a patient using a standard industrial robotic arm, the Puma 560. This became the first documented use of robotics in surgery. However, despite its positive results, the program was discontinued since the robot was not originally designed or cleared for surgical use.

Two years later, another group of surgeons performed the first laparoscopic procedure involving robotics: a cholecystectomy. This eventually led to the development of designing robots specifically for medical purposes, and has since evolved into the most recent robotic innovation: the da Vinci Xi® system.

Since their inception, surgical robots have been created for the purpose of extending the capabilities of human surgeons. They can lead to fewer incisions, sharper precision, and more versatility within medical procedures and devices, thus making surgeries safer and more efficient. But the question remains: is it affordable?

So far, the answer has been that it depends on the type of surgery.

Earlier this month, the UK Cochrane Centre and NICE published a study on robot-assisted surgeries for hysterectomies and sacrocolpopexies. The review stated that robot-assisted procedures take longer, may be associated with shorter hospital stays following surgery, and should ultimately be limited to clinical research settings, as it is unclear thus far whether they are truly safer and more effective than conventional laparoscopic approaches.

Nevertheless, this perceived lack of evidence has not prevented the diffusion and advancement of robotic surgeries. A recent survey pointed out that a total of 1 in 4 US hospitals have at least one da Vinci robot, with their presence growing in general surgeries. Europe has also been increasingly receptive to robots, with countries such as The Netherlands equipping the majority of its academic and research hospitals with robotic surgical systems.

It is reasonable to infer that surgical robotics are likely to revolutionize medical practice, as their benefits have already been demonstrated in multiple fields. In fact, the teams at ValueConnected have already quantified both the clinical and economic values of robotics in terms of both reducing the risk of infection and shortening hospitalization periods, thus leading to potential savings that could cover investments in infrastructure and robotic systems for the first few years.

While we are amazed with the current advances of surgical robotics, the existing platform of operator-machine may soon become obsolete. Both Johnson & Johnson and Google have recently collaborated to upset the market with smarter, smaller, and cheaper solutions. As Gary Pruden, Worldwide Chairman of Johnson & Johnson's Medical Devices, stated: “… We think what’s available today is really the model that’s more like the mainframe computer 50 years ago [… and] we intend to go to the iPad version.”

Will robots be able to access databases and suggest optimal surgical procedures? Or perform surgeries with minimal human interference? One thing is certain: as long as surgical robotics create value, patients, doctors, and stakeholders will look for reasons to afford it.


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