With Karen O’Shaughnessy Robotic Program at WMP

Outline

•  Robotic surgery.. What is it? •  Patient care •  A day at Westmead Private •  Robotic Surgery trends •  Adapting a standard theatre •  Costs •  Training •  Standing out from the crowd •  Australia firsts

Robot Surgery

Robotic Surgery

Components of Robotic Surgery

Valued at $3.5 million dollars

Surgeon Console

Patient Cart

The arm !!

10 lives, approx cost $5000 - $10000

Vision Cart

Standard Care of the patient

A Typical day

Robotic Surgery Trends

•  The first robotic surgery was carried out in australia over 10 years ago

To date Westmead have undertaken 600 robotic cases in 2½ year period

General and Gynae robots have taken over

Urology in USA

Trending

•  Types of Robotic cases include: –  Prostates –  Partial Nephrectomies – Hysterectomies – Rectopexy –  Anterior Resections –  Laparoscopic Chole –  Tonsillectomy

Proposed Robotic Surgery Benefits

Reduction In… •  Blood loss •  Need for a blood transfusion •  Pain and scarring •  Risk of complications •  Risk of wound infection •  Hospital stay

•  Hospital readmission

•  Needing follow-up surgery •  In days with catheter

•  Risk of deep vein thrombosis •  Recovery time

Adapting a standard theatre

•  Installation of light booms & monitor •  Ethernet checked •  Extra phone lines •  Extra power points (with uninterrupted power supply) •  Remotely monitored 24 hours a day •  Theatre repainted

72 hour before our first case!!!!!

!

1st Case Monday Morning

Additional Costs for Set Up

•  Storage •  Op Table •  Scope warmers •  Larger co2 cylinders •  Reusable instruments and trays

CSSD

•  Installation of ultrasonic bath •  Training on cleaning and sterilising of instruments

and cameras

Costs to Consider

•  Cost per case

•  Training of staff

•  Proctored cases

•  Staffing costs out of hours

Robotic Surgery Training

•  Nurse

•  Surgeon

•  Assistant

Surgeon Dry Lab

To stand out from the crowd

•  Partial nephrectomy using firefly imaging

Australian/Pacific ‘Firsts’

•  Felix Chan performed the first hysterectomy in Australia using single incision robotic technology.

•  Single site Sacrocolpopexy for pelvic floor prolapse

Australian/Pacific ‘Firsts’

1st Endoscopic Mucosal resection

Management of theatre lists around robotic surgery

•  Early starts •  Cooperation from the surgeons •  Moving cases half way through lists •  Essential to have mixed case load

And the journey continues

Conclusion

•  Clinical data just not here yet. •  Costs •  As a centre of surgical excellence, robotic

assisted surgery is the next phase in the evolution of healthcare.