Exploring the paradigm of robotic surgery and its contribution to the growth of surgical volume

Robotic surgery is an appealing option for both surgeons and patients. The question around the introduction of new surgical technology, such as robotics, with the potential link to increased procedure-specific volume has not been addressed. We hypothesize that hospital adoption of robotic technology increases the total volume of specific procedures as compared to nonrobotic hospitals.

The 2010-2020 Florida Agency for Health Care Administration Inpatient database was queried for open, laparoscopic, and robotic colectomy, lobectomy, gastric bypass, and antireflux procedures. International Classification of Diseases, 9th and 10th Revisions, codes were used. Difference in difference method was used to evaluate the impact of robotics on total procedure-specific volume of robotic hospitals versus nonrobotic hospitals before and after adopting robotic technology. Incident rate ratios from the difference in difference analysis determined the significance of adding robotics. Patient demographics were evaluated using χ test.

A total of 291,826 procedures were performed at 217 hospitals, 151 with robotic capabilities. Robotic hospitals experienced a 37% increase in surgical volume due to robotic technology (incident rate ratio 1.37, P < .05), which was consistent for each surgery except antireflux procedures (incident rate ratio 0.95). Robotic procedures had significantly higher charges for medical/surgical supplies; however, the mean length of stay for robotic procedures was significantly shorter than that of laparoscopic and open cases.

Hospital adoption of robotic technology significantly increases surgical volume for select procedures. Hospitals should consider the benefits of introducing robotic technology which leads to higher volume and decreased length of stay, benefitting both hospital systems and patients.