Launching a Successful Robotic Surgery Program

Abstract

Robotic-assisted laparoscopic prostatectomy is rapidly becoming the most commonly performed surgical approach to treat clinically localized prostate cancer. The establishment of a robotic surgery program at any institution requires a structured plan and certain key elements to be in place to allow successful development. At least five essential phases are necessary for successful implementation of a robotics program. A thorough initial design and implementation lead to the execution of clinical services that meet previously established goals. Once the execution phase is established, the next step is to focus on maintenance and growth to maximize the benefits of the program. In this paper, we discuss the necessary phases for creating a successful robotic program, paying special attention to the aspects that allowed our facility to create a profitable robotic-assisted laparoscopic prostatectomy program in year 1.

Has the robot caught up? National trends in utilization, perioperative outcomes, and cost for open, laparoscopic, and robotic pediatric pyeloplasty in the United States from 2003 to 2015

“…Conversely, being able to market the robotic platform may increase patient volume and lead to an increase in revenue. However, Palmer et al estimated that a minimum of three to five robotic cases per week were necessary to profit from robotic surgery [32], which is not the case for pediatric pyeloplasty even in high-volume institutions [5, 10, 33] (although this may be achievable in settings where the robot is shared among pediatric and high-volume adult urologists). There is one scenario in which we may have overestimated robotic costs: we cannot verify whether individual hospitals reported the cost of a single use of a reusable robotic instrument or the aggregate cost each time the instrument was used (10 uses).…”

Contemporary Referral Pattern for Robotic Prostatectomy

“…Palmer et al 21 reported on the source of referral for those undergoing RALP at our institution during the first year after a robotic program was established (FY2006) by a since relocated surgeon. During that period, only 55% of patients had been referred by another physician (of any specialty), while 90% of the patients in our current study were referred specifically by urologists.…”

Building a Robotic Program

“…A previously reported econominc feasibility study at an academic institution (12) concluded that the cost of medical and surgical supplies, including the cost of instruments accounted for 45% of total average direct cost and approximately one-third of average total cost. Operating room services and therefore, duration of OR utilization accounted for almost 30% of total average direct cost and 35% of the total cost per procedure, respectively.…”