ASCs are increasingly looking to adopt robotic technology to aid in high-acuity, highly reimbursed orthopedic procedures.
The use of robots in total knee arthroplasties increased sixfold in the last six years, according to a report from American Joint Replacement Registry.
Many orthopedic surgeons are expecting robots to become the standard.
"I have used the Stryker Mako robot to perform my partial and total knee replacements and total hip replacements (including revisions) for over seven years," Anthony Melillo, MD, orthopedic surgeon at Houston-based Bay Oaks Orthopedics & Sports Medicine, told Becker's. "I was hesitant at first since it was a new concept. But I can now say that I will never do another joint replacement without this technology. Bottom line, robotics in total joints, especially by 2030, will be the standard of care."
But robots are expensive, and many ASCs do not have the resources to potentially spend more than $1 million on the technology.
"There are many advantages I have seen with robotic technology, including improved accuracy and consistent surgical results and also the ability to plan and streamline surgical workflow as we have in our ASC," Joseph Nessler, MD, orthopedic surgeon at St. Cloud Orthopedics in Sartell and St. Cloud, Minn., told Becker's. "The biggest drawback is initial startup costs, but most manufacturers are becoming very creative in financing, rebates and incentives, so this once major hurdle is slowly becoming less of a barrier. The other concern is inconsistency in robotic platforms. Some so-called robotic platforms today are just glorified navigation systems, and surgeons and administrators need to do their homework when evaluating different manufacturers' offerings."
Being selective about the inclusion of robots is critical, Alfonso del Granado, administrator and CEO of Lubbock, Texas-based Covenant High Plains Surgery Center, told Becker's in September. He added that leasing a DaVinci surgical robot was one of the best decisions his team has made in the last year.
"Although the cost per case is much higher on average than the same procedures performed laparoscopically, we had unused time slots that could now be filled productively, and we were able to help one of our partner groups whose members were having trouble booking robotic cases at our partner hospital across the street," he said. "So far the financial impact has been positive, and the indirect benefits have been significant."
But Mr. del Granado remains wary of how beneficial the investment actually turns out to be.
"Although we have robots for our total joints program and our general surgery service line, these were necessary to bring new volume into our centers, especially total joints," Mr. del Granado told Becker's. "But of course the added expenses are not accompanied by concomitant increases in reimbursement rates, so we work with our surgeons to limit the number and types of cases that get scheduled on the robots. I should note that our general surgeons have been excellent partners in communicating the rationale for every robotic case, but it behooves everyone to keep an eye out to protect against robotic mission creep."