"I see these robots as tools," Choset said. "As those tools get better and better, you don't need as much specialization to do a task. Some procedures today [such as colonoscopies] we might call routine procedures and they are being done by non-surgeons, so surgeons are freed up to do more complicated tasks.
"I also do see robots being able to provide more feedback and visualization so physicians can make more informed decisions," Choset added.
While Choset doesn't see robots making medical decisions, he does expect them to improve accuracy during minimally invasive operations, damage less tissue and reduce the possibility of infection. As a result, they also hold the promise of decreasing costs from patient readmissions.
For example, heart bypass surgery traditionally requires that a patient's chest be opened by way of a one-foot long incision. A da Vinci robotic surgical system can perform the same operation by using three or four one centimeter incisions in the chest. Smaller incisions mean less tissue damage and a faster recovery.
Since the Affordable Care Act of 2010 created both the Hospital Readmissions Reduction Program and a new pay-for-performance system based on quality of care -- not the number of procedures -- robots could end up paying for themselves.
Snehal Chougule, a marketing executive with market research firm Allied Research, said a hospital that spends from $1 million to $2 million on a da Vinci robotic system, not including a $150,000 maintenance contract, could recoup its costs within two years.
"Hospitals consider many factors while offering robotic surgery, such as patient benefit, hospital competition and hospital costs. The trend toward robotic surgery also brings up such issues as overall healthcare spending, the comparative effectiveness of treatment options and the pace of technology adoption. Thus, it is worth to invest in surgical robots, despite of its high cost and comparative scant research," said Chougule said.
For example, Chougule said, one hospital with around 300 beds bought a surgical robotic system for $1.8 million and then used it to perform 650 surgeries last year. The number of surgeries is likely to reach 750 patients this year, as more prospective patients learn the technology exists.
While the particular hospital was last in its market to buy a surgical robot, it became a leader by performing twice as many robotic surgeries as other area hospitals and boasted the second-highest volume in the state, Chougule said.
"Many physicians say capturing the market share can be the biggest advantage of investing in the robot. So, if some hospitals can market this and can be first in their area to do so, then it will be easy to get money back in couple of years because they are getting patients and recognition for being advanced hospitals as well," he said.
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