Countdown to OR Manager Conference: Robotics in the ASC—Technology trends and what you need to know

Editor's Note

A panel discussion at last year’s OR Manager Conference highlighted the benefits and challenges of introducing robotics into ambulatory surgery centers (ASCs), particularly for joint replacement surgical procedures. Hosted by Surgical Care Affiliates (SCA) and Stryker leaders, the session emphasized how robotic technology can help improve surgical outcomes, reduce costs, and boost efficiency. According to the panelists, robots have been used in joint replacement surgeries since the early 1990s, with the primary goal of enhancing surgical precision.

Comprising the panel were Kevin Barga, MS, RN, CCRP, senior manager, clinical affairs, at Stryker; Amy Brinkman, certified surgical tech and sterile processing supervisor at SCA; Andrea Coppolecchia, MPH, director of health economics and clinical regulatory at Stryker; Amy Shepard, BSN, RN, PACU nurse manager at SCA; and Amy Zanoth, RN, OR manager at SCA. The panel cited research showing that robotics in joint replacement procedures have led to improved component placement, reduced wear, and minimized surgical trauma, all of which contribute to fewer revision procedures.

Studies have also shown that robotic-assisted surgeries result in better soft tissue protection, with real-time data available to the surgeon for more precise decisions. Reduced postoperative pain and decreased opioid use were also highlighted as significant benefits, along with shorter hospital stays and lower rates of readmission. Patients who undergo robotic-assisted joint replacements tend to recover faster and with fewer complications, leading to higher satisfaction rates.

Here are some key points covered by the panel:

• Robotics in ASCs helps simplify procedures, minimize human error, and improve outcomes.
• The technology is already widely adopted in joint replacements and enhances surgical planning and precision, reducing revision rates and trauma.
• Major challenges include the high cost of robots, staff training needs, and increased initial OR time.
• Robotic systems vary by manufacturer, with some offering more versatility in performing different types of procedures.
• Evidence from clinical studies shows robotic-assisted procedures result in less tissue damage, reduced inflammatory responses, and lower pain and opioid use.
• Studies show cost savings with reduced length of stay and decreased use of health services postoperatively, including fewer emergency room visits and readmissions.
• The learning curve for robotic surgery typically levels out after 12 to 20 cases, with staff and surgeons achieving time-neutral outcomes.

Despite the clear clinical benefits, the panel acknowledged the adoption of robotic systems requires a significant financial investment. Robots are expensive, and there are additional costs related to training surgeons and staff, as well as modifying OR space to accommodate the equipment. However, the panelists explained the long-term cost savings could offset these initial expenditures. Reduced length of stay, lower postoperative care costs, and more efficient use of surgical instruments contribute to these savings.

For example, a study from the University of Wisconsin demonstrated that the 90-day episode cost for robotic knee surgeries was more than $2,000 lower than for manual procedures. Additionally, hospitals with more than 50% robotic usage saw even greater savings and better performance in bundled care programs, underscoring the financial advantages of robotics in high-volume facilities.

Another example is SCA’s St. Cloud Surgical Center, of which experience highlighted streamlined processes, reduced infection rates, and the importance of surgeon engagement and teamwork. To implement robotic surgery, they created a specialized team and streamlined instrument trays to reduce preparation and turnover time. The center went from performing four to six procedures per day to between 12 and 14, all while reducing costs through strategic vendor partnerships and equipment optimization. The success of the program was driven by strong surgeon engagement, continuous staff education, and careful patient selection.