Achieving robotic program best practice performance and cost versus laparoscopy: Two case studies define a framework for optimization.

Background: Robotic surgery is seen by many hospital administrators and surgeons as slower and more expensive than laparoscopic surgery despite the implementation of commonly held robotic best practices. Multiple factors, including surgeon learning curves and program governance, are often overlooked, precluding optimal robotic program performance.

Methods: An assessment of several leading robotic surgery publications is presented followed by real-world case studies from two US hospitals: an existing robotic program in a mid-sized, regional hospital system and a small, rural hospital that launched a new program.

Results: Improvements in robotic surgery costs/program efficiency were seen at the hospital system vs baseline at 18 months post-implementation; and high-performance robotic efficiency and cost benchmarks were matched or surpassed at the rural hospital at 1 year post-launch.

Discussion: When best practices are utilized in robotic programs, surgical case times, costs, and efficiency performance metrics equaling or exceeding laparoscopy can be achieved.