Impact of non-surgical OR time on efficiency and costs with Hugo™ RAS

Area of Science:

• Minimally Invasive Surgery
• Robotic Surgery Systems
• Surgical Efficiency and Cost Analysis

Background:

• Robot-assisted surgery (RAS) adoption is rising, with new systems like HugoRAS entering the market alongside established daVinci systems.
• Non-surgical, patient-independent time (NonSPIT) significantly impacts cost and efficiency in robotic procedures.
• Understanding NonSPIT is crucial for healthcare institutions evaluating new RAS adoption.

Purpose of the Study:

• To compare perioperative NonSPIT between the HugoRAS and daVinci Xi robotic systems in pelvic procedures.
• To analyze the impact of personnel experience on NonSPIT for both robotic systems.
• To estimate the cost implications of NonSPIT differences for HugoRAS versus daVinci Xi and open procedures.

Main Methods:

• Prospective, single-center study in Germany comparing HugoRAS and daVinci Xi robotic pelvic procedures (RPP).
• Retrospective analysis of open pelvic procedures (OPP) for comparison.
• NonSPIT (setup, docking, undocking, cleanup) was meticulously recorded and analyzed, correlating with staff experience.

Main Results:

• HugoRAS NonSPIT was longer than daVinci Xi (94.3 vs. 81.6 minutes), accounting for 40.0% of total time vs. 36.7%.
• This time disadvantage for HugoRAS was overcome after 10-15 cases per scrub nurse.
• Setup time constituted the largest portion of NonSPIT difference; HugoRAS setup was slower than Xi for both novice and experienced teams.

Conclusions:

• Initially, HugoRAS may present a time inefficiency compared to daVinci Xi, primarily due to setup.
• The learning curve for HugoRAS is estimated at $7017.87 per nurse until Xi efficiency is matched.
• Despite initial challenges, HugoRAS offers an economical alternative, especially considering its lower per-case instrumentation costs.