Hysterectomy is the second most common surgery for women performed in the U.S., second only to cesarean section, and increasing numbers of surgeons are opting to perform it while sitting at the controls of the da Vinci surgical system. Intuitive Surgical’s workhorse has dominated the robotic surgery market for decades thanks to patents protecting its key design features. Those patents have begun to expire, however, opening the door for increased competition that is expected to drive down the cost of the technology as several companies enter the field with streamlined platforms designed with budget-conscious facilities in mind.
There are currently about a half-dozen new robotic platforms on the market or in the pipeline that will vie with the da Vinci for OR space, according to John Lenihan, MD, a gynecologic surgeon at MultiCare Tacoma (Wash.) General Hospital. Dr. Lenihan calls the da Vinci the “Cadillac” of robotic platforms and believes it will continue to lead the market for the foreseeable future, but he says its multimillion-dollar price tag and the ongoing expense of maintaining it — instrument arms that cost $750,000 each and service contracts that run $100,000 per year — have priced it out of most outpatient surgical facilities. “It’s never been a realistic option for surgery centers,” he says.
Some of the new robots that are set to enter the field are being developed by major players in the field of surgery, including Medtronic and Johnson & Johnson. That will allow for the bundling of supply costs, another factor that could lead to more facilities adding the technology. For example, one of the major players could include the cost of the robot into a larger contract with facilities, which would purchase surgical supplies — gowns, masks, drapes, sutures — from the robot manufacturer in exchange for getting the platform at a discounted price.
The increased competition among robot makers and growing interest in robotic hysterectomy among gynecologic surgeons will lead to about 80% of hysterectomies being performed with robotic assistance over the next decade, according to Dr. Lenihan. “Not only because the cost of the technology will come down, but also because newer robots will be easier to use,” he says. “Cost-effective and user-friendly platforms will be ideally suited for surgery centers, where specialized teams can focus on performing robotic hysterectomies easier and faster.”