More than 38 leaders joined Becker’s to discuss ASC growth opportunities in the next five years. Several pointed out ASCs are poised for substantial expansion in MIS as technological advancements accelerate and outpatient settings become increasingly favorable for complex procedures.
Sean Gipson, division CEO and president at Fort Worth-based Remedy Surgery Centers, highlighted MIS as a key growth area.
“With the rapid advancement in surgical technology, and a competitive manufacturing industry, procedures such as laparoscopy and robotic-assisted surgeries are becoming increasingly popular,” he said. “These types of technologies are perfect for the outpatient setting given short recovery times, lower total surgical costs and shorter anesthesia times. As the market continues to grow, I most certainly believe that in the next five years the minimally invasive surgical market will land in the top three areas of growth for ASCs.”
Outpatient spine procedures grew among Medicare patients between 2010 and 2021, with significant yearly growth at ASCs. The findings, published in the March 2024 issue of the North American Spine Society Journal, found the total number of outpatient spine procedures rose about 193% over 2010 to 2021. The compound annual growth rate for outpatient cases per year was 9.9% for hospital outpatient departments and 15.7% for ASCs.
As more procedures shift from inpatient to outpatient settings, the trend is expected to gain further momentum. The global spine biologics market is expected to reach $30.43 billion by 2034 due to factors including increased prevalence of spinal disorders, growing preference for minimally invasive procedures and favorable reimbursement policies.
“I believe spine will continue to be an area of growth as new technology allows for increasingly minimally invasive procedures to replace surgeries that were traditionally only possible in the hospital inpatient setting,” said Harel Deutsch, MD, co-director of Chicago-based Rush Spine.”
Along with these clinical advancements, the financial benefits of performing MIS in ASCs are notable.
“Providing these procedures in the ASC setting allows for a decreased cost per case,” Lisa Donaldson, director of nursing at Baylor Scott & White Surgicare Fort Worth, told Becker’s.
One of the technological innovations propelling this migration is robotic-assisted surgery, such as the Da Vinci Xi system. As the capabilities of robotic and navigation systems continue to improve, an increasing number of spine procedures will likely be approved for ASCs.
“I believe the next best steps are increasing minimally invasive spine surgery, percutaneous spine surgery such as kyphoplasty, as well as surgeries for hernia repairs and even, possibly, cholecystectomies,” Stephen Esper, MD, director of Pittsburgh-based UPMC Center for Perioperative Care, told Becker’s. “Of course patient selection will be important especially concerning obstructive sleep apnea with high BMI, ICD, CHF among others.”
Beyond financial and efficiency benefits, MIS techniques offer notable advantages for patient outcomes. Reduced recovery times, enhanced surgical precision and lower complication rates contribute to higher patient satisfaction and lower overall healthcare costs by minimizing hospital stays.
“Robotic-assisted procedures and minimally invasive techniques reduce recovery times, enhance precision and lower complication rates,” Renee Oliveira, chief operations and marketing officer at Integrated Medical Care, said. “These advancements improve patient satisfaction and reduce overall costs by minimizing hospital stays.
A small study from Newport Beach, Calif.-based Hoag Orthopedics found more patients preferred to have spine surgery at an ASC than a hospital. Of the 58 people surveyed, 30 said they would prefer to undergo a spine operation in an ASC, while 28 said they would prefer a hospital.
Despite the promise of MIS in ASCs, concerns persist regarding the accuracy and safety of these procedures. However, improvements in navigation technology are expected to bolster the reliability of these techniques.
“Navigation in the outpatient setting will enhance the accuracy and safety of minimally invasive procedures,” said Daniel Mulconrey, MD, an orthopedic spine surgeon at Peoria, Ill.-based Midwest Orthopaedic Center. “This improvement should inevitably increase the volume of procedures performed in ASCs. The challenge will be managing expenses related to navigation technology.”
As technology continues to evolve, the trajectory for MIS in ASCs remains positive. With continued innovation, procedural migration, and improved patient selection, the next decade is poised to bring unprecedented growth in minimally invasive surgery across outpatient settings.
