Evaluating the Basic Requirements for Implementing Robotic Surgery: A Recommendation Report

Rec Report for Robotic Surgery1

Evaluating the Basic Requirements for Implementing Robotic Surgery: A Recommendation ReportPrepared for: Dr. Jay StratPrepared by: Oliver Sroka, Assistant of Dr. Jay Strat

Table of Contents

Executive Summary2Research Report3 Introduction3 Methods3 Results4-5Recommendation5Implementation Plan5Evaluation Plan5References5-6

Executive Summary

On August 1st, 2014 a recommendation for more robotic assistance in surgery was proposed by Dr. Jay Strat. As an assistant to Dr. Strat, I was selected to start researching the benefits of such a project and if a project like this is even possible. To make a project like this effective, one must make the project as large scale as possible, so that patients around the globe benefit from it.

Patients around the world are having surgery performed by surgeons instead of robots. While the surgeon may be very good in their profession, humans simply do not have the same precision as robots do. The people who are getting operated on could benefit greatly from robotically assisted surgery, the extra amount of precision that robots provide can go a long way to helping a patient recover successfully from their surgery. A research study was conducted to see just how feasible a large scale shift toward robotic surgery is possible. We found that if hospitals would agree to help fund the project, there would be plenty of potential to implement such a project. However, with millions of dollars on the line, we had to ensure that this was worth the effort.

Before continuing with the project, there had to be an abundance of research done to see just how beneficial robotic surgery could be in comparison to the standard surgeries of today. We compared the average time of robotic surgeries with regular surgeries, the average number of complications of each type of surgery, and the average recovery time from each surgery. Afterward, patient surveys were done around the globe to see if patients were interested in such a surgery. This was done because the patient has the ultimate say in whether or not they want to do surgery and what kind they would like to do. Furthermore, research was done to see what types of surgeries would benefit most from robotic assistance. With all this said and done, we had to evaluate the cost of the machinery for each hospital wanting to join in on the program in order to see if the benefits outweigh the costs.

After the research was done, we found that the majority of surgeries could be aided with robotic assistance and that patients around the world were willing to pay a little extra for a safer, quicker surgery. We decided to go ahead and work on the project from that point on.

Implementing this idea could take many years due to how large of a scale this project is. On November 24, 2014 we decided to take action and start promoting the plan at hand. Several steps have already gone into effect and we except to complete the project by the deadline of November 24, 2024.

Research Report

IntroductionRobotic surgeries have been around since 1990, when the first robot was approved by the FDA. Since then, technology has allowed robots to mature into the safest way to have an operation done. Robots have significant benefits in regards to surgery; they give the surgeon more precision, they make the operation less risky, and they lower the amount of time it takes to recover from surgery. The benefits of robots not only help the patient inside the operation room, but they help doctors outside of it. Robots are now capable of being controlled from hundreds, even thousands of miles away. The patient is now able to be operated on by the best surgeons in the world. Not only does this give doctors and patients flexibility, but it also reduces the risk of infection because the doctor is not actually in the room during the operation. The significance of these findings brings us to believe that there should be more surgeries that are robotically assisted than regular surgeries.

MethodsAn assortment of methods were developed to conduct the research study, including seeking information from both primary and secondary sources. Tasks were organized according to significance to the projects timeline and broken down accordingly below. The main goals of these efforts were to establish whether or not the project was worth putting into effect or not.1. Obtain basic information on robotic assisted surgery, specifically in regards to the benefits regular surgery cannot produce.2. Find out how many machines each hospital would need and how much it would cost to implement the machines. 3. Research if the benefits would outweigh the costs of implementation. 4. Survey patients to see their attitudes toward robotic surgery and whether or not they are willing to pay extra for it. 5. Research doctors attitudes toward switching from regular surgery to robotic surgery. 6. Analyze and organize the information obtained from the research to construct the recommendation report.

ResultsAll of the above tasks have been completed and readied for the recommendation report as of November 24th, 2014.

Task 1: Obtain basic information on robotic assisted surgery, specifically in regards to the benefits regular surgery cannot produce.In this first task, we researched the possible benefits a robotically assisted surgery could have. According to surgeon Dr. David Samadi, robotic surgery offers greater precision than regular surgery and thus limits the amount of complications that could happen during the surgery [1]. Also, we found that the chances of infection are greatly decreased because the surgeon does not have to be in the room when operating. Furthermore, we saw a decrease in recovery time for patients who underwent robotically assisted surgery. This is due to the smaller, more precise incisions that can be made by a robot.

Task 2: Find out how many machines each hospital would need and how much it would cost to implement the machines. Through our research, we figured out that each hospital would need about 2 machines to provide surgeries to the local patients. We based this off of hospitals that are already using machines like the ones we plan to implement. Also, the cost of two of these machines would probably be around 5 million dollars [3], however in retrospect that is not a lot for a hospital because the average hospital generates about 200 million in revenue a year.

Task 3: Research if the benefits would outweigh the costs of implementation. With all of the information needed to make a decision, we decided that the benefits of robotically assisted surgery do outweigh the cost of installation.

Task 4: Survey patients to see their attitudes toward robotic surgery and whether or not they are willing to pay extra for it. For the majority of the population, robotic surgery seems like the right choice for them. Around 80 percent of patients answered that they would rather have less complications and less chance of infection even if it meant they had to pay a little more. Overall, patients are for robotic surgery.

Task 5: Research doctors attitudes toward switching from regular surgery to robotic surgery. We have seen a swing toward robotic surgery in recent years. This is due to the realization by doctors that robotic surgery can benefit their patients in ways their hands cannot. However, the majority of doctors still perform surgery the regular way and there is a high demand to teach doctors to perform robotically assisted surgery [2].

Task 6: Analyze and organize the information obtained from the research to construct the recommendation report. After completing the research study and organizing all the information, this recommendation report was composed to break down the research and process of creating and incorporating robotic surgery into a medical setting.RecommendationWith all of the research conducted, it is in the best interest of hospitals to start implementing more robotic surgeries into their facilities. Research supports that patients and doctors both support the idea of this project and the costs of the machinery will not stop hospitals from purchasing them. The benefits that robotic surgeries offer are too great to not implement them. With all this technology just lying around, we might as well use it to benefit those who are not as fortunate and need surgery.

Implementation PlanThe main way we plan to get hospitals and other medical facilities to switch from regular surgery to primarily robotic surgery is by meeting with the president of operations at the facility and convincing them of the benefits. Every hospital wants to be the most innovative and advanced hospital in the world, it promotes business and benefits their reputation. If we can get a couple of big name hospitals to support this initiative then the project could really start to change medicine. Obviously there will be those who do not agree with what we have to say or do not have the resources to implement the system right away, but I believe a solid 10 year plan can do wonders for hospitals like that. Another step of the project is to set up new programs in medical schools to teach medical students who want to be surgeons how to operate state of the art equipment. By doing so we ensure the future of medicine will be skilled enough to handle the surgeries.

Evaluation PlanAfter the plan is implemented, we plan to analyze how our project is doing. For long term results, we will go to each hospital that invested in our project 5 years after they started using robotic assistance and get statistical data from their machines. Afterward, we will compare those statistics to the statistics prior to the machines. Our hope is that we find a substantial decrease in number of infections after surgery, number of complications during surgery, and average time of recovery after surgery. For short term results, we will survey patients and see just how happy they were with the surgery they had performed on them.

References

[1] Glass, N. (1970, January 1). Would you have surgery at hands of a robot? Retrieved November 30, 2014, from http://www.cnn.com/2013/08/02/tech/da-vinci-robot-surgery/

[2] McNamee, D. (n.d.). Are robots the future of surgery? Retrieved November 30, 2014, from http://www.medicalnewstoday.com/articles/280518.php [3] Stroud, M. (2011, November 9). Do Nonprofit Hospitals Make Too Much Money? (n.d.). Retrieved November 30, 2014, from http://www.citylab.com/work/2011/11/do-nonprofit-hospitals-make-too-much-money/450/