adds Dmitry Oleynikov, MD, FACS, professor in the Department of
Surgery at the University of Nebraska Medical Center College of
Medicine in Omaha. "Ultimately, this technology will let surgeons do
more audacious and complex surgeries without big incisions."
Dr. Oleynikov says robots are being used for "just about every single
abdominal operation you can think of" in inpatient settings. "For out-
patient surgical cases," he says, "things like inguinal hernia, umbilical
hernia, gallbladder — fairly straightforward, low-risk procedures —
are being done with robots."
Yet a robot like the da Vinci is a difficult proposition for outpatient
ORs, says Dr. Oleynikov, citing these factors.
• Size. "The robot is big, so it requires a pretty large OR," he says.
"Most [same-day] ORs are smaller."
• Staff training. "Robots are complicated," he says. "They require
docking, undocking, maneuvering and positioning."
• Reimbursement. The procedures in ASCs are reimbursed less
than the same types of procedures in hospitals. "An expensive robot
that may take additional time to perform an operation is going to
severely erode the ASC's bottom line," he says. "Depending on the
procedure, the additional cost of using the robot versus straight
laparoscopy is anywhere between $1,500 to $3,000."
Robot Lite
Are there less expensive, more functionally limited robots, or prod-
ucts that leverage robotics, that outpatient facilities can consider? Dr.
Oleynikov says such products are emerging, like a handheld robotic
needle driver that lets you bend at the wrist. "Some companies are
looking to create fairly rudimentary robotic tools — kind of like a
'Robot Lite,'" he says. "But right now, there really isn't an easy-peasy,
cheap hybrid robot on the market."
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