robotic surgery

What’s the Minimum Annual Case Volume for a Robotic Surgeon? Part 2

Building on last week’s CAVA blog, the literature has identified a learning curve of 25-90 cases required to be safe AND proficient, with the average surgeon at about 50 cases.

Likewise, simulation has been studied to shorten this initial learning curve by approximately 50% so that 20-25 cases is achievable.  SAGES and urologic societies support the above findings with excellent studies showing docking time efficiency is achieved at 20-25 cases.  Specimen margins, lymph nodes, blood loss, etc. have all been used as proxies for the learning curve and validate the above findings. ACOG committee opinion 628 also addresses this.  Maintenance of skills have been less well documented, but it has been suggested at 12 to 50 cases and the AAGL has published 20 as the standard.
There are some excellent studies that show that at less than 20 cases per year, operative times (and therefore risk), EBL and complications all increase.  When case volume are greater than 40 cases per year, all of these numbers fall to rates that are comparable with laparoscopic or open surgery.  Simulator performance also deteriorates as the time between cases increases.

What’s the Minimum Annual Case Volume for a Robotic Surgeon? Part 1

The literature supports that a surgeon should use the robot at least every 2 weeks in order to minimize degradation of skills. It is the consensus in robotic programs that 24 cases is the very minimum annually.  The fact is, very few surgeons would feel comfortable revealing to their patients that they do less than 24 cases a year and still consider themselves an expert.
Low volume robotic surgeons WHO DO NOT COMMIT to robotics and simulation are well known to be less efficient with poorer clinical and financial outcomes.  Both national benchmarking data as well as CAVAlytics data demonstrate the same.  This fact is obvious: the more operations a surgeon performs, it would be expected that he or she would become faster and better.  As simulation then progresses and evolves into procedural simulation (where actual operations on simulated tissue rather than skill drills are available), low volume surgeons should be able to maintain their skillset at a very high level despite the restricted access to actual, live tissue.  The goals of higher surgeon quality with better financial and clinical outcomes are exactly what CAVA holds as our core objectives for our clients’ robotic programs.
Remember, however, that simulation is not a means to substitute for actual case experience but rather it is an alternative that is available that is unique to robotics.  Most programs that have the minimal governance and a functional, active robotic program require BOTH simulation and case volume.

National Forum on Quality Improvement in Health Care on Dec. 4-7, 2016, in Orlando, Fl.

CAVA Robotics will be exhibiting at booth #210 at next month’s annual National Forum on Quality Improvement in Health Care on December 4-7, 2016, in Orlando, Florida. The exhibition will be held in the Cypress Ballroom at the Orlando World Center Marriott. IHI’s National Forum is the premier conference for people committed to the mission of improving health care. This annual event draws nearly 6,000 health care professionals from around the world in person and thousands more via satellite broadcast. CAVA Robotics makes a significant contribution to The Institute for Healthcare Improvement’s conference, which takes a unique approach to working with health systems on improving quality, safety, and value in health care. This approach is called the science of improvement, and is an applied science that emphasizes innovation, rapid-cycle testing in the field, and spread in order to generate improvement. It is characterized by the combination of expert subject knowledge with improvement methods and tools. It is multidisciplinary — drawing on clinical science, systems theory, psychology, statistics, and other fields. CAVA stands as a sterling example of these approaches to healthcare improvement. Please be sure to visit us at the IHI conference!



Growth in Global Robotic Market Projected…Will Your Hospital Be Prepared? (Part 2)

Rise in healthcare expenditure, growing elderly population, technological advancement, increasing incidence of chronic diseases, rise in consumer spending in healthcare, high incidence of medication errors  and growing demand for robot-assisted surgical systems are expected to drive the global market for robotic surgery. In addition, a rise in the need for faster recovery, reduce pain and discomfort, and increasing awareness about benefits of robotic surgery are expected to fuel adoption supported by new product launches, increasing number of collaborations and partnerships and a rise in the number of mergers and acquisitions.

Let CAVA Robotics assist your facility in establishing the best practice design and governance of an optimized robotic program.  Now is the time to prepare for the next decade in robotics.

Growth in Global Robotic Market Projected…Will Your Hospital Be Prepared? (Part 1)

Read the healthcare and business media and you’ll regularly how its projected that North America, followed by Europe, will have the largest market for robotic surgery over the next decade due to developed healthcare infrastructure, increasing incidence of chronic diseases and technological advancement in the region. Asia is expected to show high growth in the robotic surgery market in next few years as well due to government initiatives and the rise in awareness about robot-assisted minimally invasive surgeries in this region. However, not knowing how best to design and run an optimized robotic program will be one of the largest limiting factors for hospitals and IDNs, and this is where CAVA Robotics can help your facility.  Let us show you what you MUST know to capitalize on the ROI or computer-assisted surgery in the coming decade.

Robotics in Smaller Hospitals? MUCH Better Guidance is Needed!

Here’s an interesting piece on the challenges small hospitals face in assessing whether to invest in a robotic program.  CAVA encounters stories like this one regularly. What you read here is fairly typical of the approach many small hospitals take.  Be warned, however, there is MUCH MORE any small hospital should be aware of in making a go/ no-go decision to get into into robotics than the info presented here. While this article provides insight into some of the questions, the understanding here is VASTLY incomplete. Determining cost-effectiveness is a complex 21-element algorithm. CAVA can help any smaller hospital considering a robotic program to approach this optimally.  The difference can be measured in months vs years to program success (if at all), as well as hundreds of thousands, if not millions of dollars, in bottom line impact.


A Sneak Peek…Get Ready!

A sneak peek into some of the exciting advances in the computer-assisted surgical environment over the next decade. CAVA approaches the design and optimization of all our client’s robotic programs with a vision to the future, meaning that hospitals must establish robotic program design, governance, and infrastructure that is agnostic to the technology vendor. There is much evolution and new competition coming to computer-assisted surgery!  Get ready.



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