11 things to know about robotic surgery

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Robotic surgery is being performed more, both in the inpatient and outpatient spheres. While some surgeons still do not see the value in this technology, others swear by it.

Here are 11 things to know about robotic surgery.

1. In 2000, the da Vinci Surgery System became the first robotic surgery system approved by the FDA for general laparoscopic surgery and made commercially available in the United States, according to a Health Research Funding report. More than 1.5 million da Vinci procedures have been performed worldwide since 2000. It is used to perform minimally invasive surgeries in a number of specialties, including cardiac, gynecology, urology, general surgery and colorectal procedures.

2. Intuitive Surgical, the company that manufactures and markets the system, shipped 118 systems in the second quarter of fiscal year 2015. According to its most recent financial report, the company earned a non-GAAP net income of $173 million.

3. Approximately 400,000 robotic surgeries were performed across all types of surgery in the United States in 2012. The rate of robotic surgeries is increasing by 25 percent annually.

4. Analysts from Grand View Research predict the global medical robotic system market will reach $17.9. billion by 2020. The compound annual growth rate is anticipated 12.7 percent from 2014 to 2020.

5. The market is expected to grow due to technological innovations such as the capsule robot system, software/applications and imaging system, increasing geriatric population base and increasing per capita healthcare expenditures. Major players in the market include Intuitive Surgical, MAKO Surgical (now owned by Stryker), Accuray, Mazor Robotics and Titan Medical.

6. As of 2013, 15 percent of unicompartmental knee arthroplasties in the United States were performed with robotic systems. The expectation is that those numbers will grow over the next five to 10 years. According to projections, the number of robotic partial knee arthroplasties is expected to rise to 37 percent in 10 years. In the next 10 years, 23 percent of total knee arthroplasties are expected to include robotic technology.
 
7. The high costs of robots have made many healthcare providers and patients hesitant to utilize the new technologies. A 2013 study found robotic prostatectomy cost an average of $2,118 to $2,274 more per case than a laparoscopic prostatectomy.

8. A 2010 perspective published in The New England Journal of Medicine notes on average the additional variable cost of using a robot-assisted procedure was about $1,600 — that's about 6 percent of the cost of the procedure. The analysis was conducted across 20 types of robotic surgery that existed in the literature.

9. Jess Lonner, MD, of Rothman Institute in Philadelphia, and his colleagues examined 200 cases using Blue Belt's Navio technology with 50 percent done in the surgery center; the rest were done at the hospital, and all patients were discharged home. The average cost of care at the hospital inpatient was $16,495; the hospital outpatient was $13,295 and the ASC was $9,969.

10. The list price on a first generation robotic system in Dr. Lonner's study was $1.2 million and the break-even on return-on-investment was 240 cases; however the list price on the second generation robotic system is $450,000 and the break-even on return-on-investment is 60 cases. First generation devices have an approximate set-up time of 40 minutes, as compared to second generation devices with a 15 minute set-up time and no complex calibration.

11. Increasingly, outpatient surgery centers are adopting robotic technology. In April, Eric Green, MD, of St. Cloud (Minn.) Surgical Center performed the first CT-free robotics-assisted partial knee replacement in the state by a surgical center using Blue Belt Technologies' Navio Surgical System. As recently as July, Piccard Surgery Center in Rochville, Md., added a Navio robotic orthopedic surgical system and Minnesota Valley Surgery Center in Burnsville incorporated the MAKOplasty procedure.
 
In addition, Blue Belt Technologies partnered with SurgCenter Development. The partnership will enable SurgCenter Development locations to develop orthopedic robotics programs with Blue Belt Technologies' Navio Surgical System.

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