Creating Value with a
da Vinci Surgery Program
Presenter Name
Presenter Title
Top Concerns Facing Hospital
CEOs
Why da Vinci® Surgery?
Why da Vinci® Surgery?
Value = Efficacy ÷ Invasiveness2
•
•
da Vinci
Alternative
Therapies (radiation)
•
Open
Surgery
da Vinci Incisions
Open Incision
Improving Patient Outcomes
& Satisfaction
Improving Patient Outcomes &
Satisfaction
In this Section
• Improved clinical
outcomes
• Faster recovery time
• Faster return to normal
function, activities
• Excellent patient
satisfaction ratings
Conclusion
da Vinci Surgery offers the
potential benefits of a minimally
invasive procedure for complex
conditions, with excellent
outcomes and fast recovery —
across multiple specialties. This
results in a very high level of
patient satisfaction and a
willingness to recommend da
Vinci Surgery to others.
Clinical outcomes - Cancer
Hysterectomy
Prostatectomy
da Vinci Prostatectomy: Patel VR, et al. Robotic radical prostatectomy: outcomes of 500 cases. BJU Int. 2007 May;99(5):1109-12. Open prostatectomy:
Scardino PT. Open radical retropubic prostatectomy. Presented at the American Urological Association’s Carcinoma of the Prostate Course, San Francisco,
CA, Sept. 30 – Oct. 1 2005. Lap prostatectomy: Touijer K, et al. Quality improvement in laparoscopic radical prostatectomy for pT2 prostate cancer:
impact of video documentation review on positive surgical margin. J Urol. 2005 Mar;173(3):765-8. p. 766 da Vinci Hysterectomy: Boggess JF, et al. A
comparative study of three surgical methods for hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am Jrnl
of Obst & Gyn. Oct 2008; 360. e1-360e9
Clinical outcomes - Cardiac
da Vinci Mitral Valve Repair: Murphy D, et al. Multicenter mitral valve study: a lateral approach using the da Vinci Surgical System. Innovations: technology
and techniques in cardiothoracic and vascular surgery. 2007 March; 2(2): 56-6
Sternotomy Valve Surgery: Society of Thoracic Surgeons Adult CV Surgery National Database - Fall 2005 Executive Summary
Return to normal function
For men… post-prostatectomy
Sexual Function: da Vinci: Kaul S, et al. Robotic radical prostatectomy with preservation of the prostatic fascia: a feasibility study. Uro. 2005; 66, 1261-1265
Open: Parsons JK, et al. Effect of methylprednisolone on return of sexual function after nerve-sparing radical retropubic prostatectomy. Urology. 2004 Nov;64(5):987-90
Lap: Su, L.M., et al. Nerve-sparing laparoscopic radical prostatectomy: replicating the open surgical technique. Urology. 2004; 64, 123
Continence: da Vinci: Patel VR, et al. Robotic radical prostatectomy: outcomes of 500 cases. BJU Int. 2007 May;99(5):1109-12
Open: Walsh PC. Patient-reported urinary continence and sexual function after anatomic radical prostatectomy. J Urol. 2000 Jul;164(1):242. p.59
Lap: Su, L.M., et al. Nerve-sparing laparoscopic radical prostatectomy: replicating the open surgical technique. Urology. 2004; 64, 123
Return to normal activities
For women … post-hysterectomy
Bell MC, et al. Comparison of outcomes and cost for endometrial cancer staging via traditional laparotomy, standard laparoscopy
and robotic techniques. Gynecol Oncol. 2008 Nov;111(3):407-11
Improving Patient Outcomes & Satisfaction
Safety & Quality of Care
Safety & Quality of Care
In this Section • Reduced blood loss
• Shorter OR times
• Reduced risk of hospital
acquired conditions
• Lower complication
rates
• Lower conversion rates
Conclusion da Vinci Surgery has been
proven to help minimize risks
and complications, as well as
rates of conversion to open
surgery, maximizing patient
safety and quality of care for
even the highest-risk patients.
Blood Loss
Benign Hysterectomy
LEFT: Payne TN, Dauterive F. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community
practice. J Minim Invasive Gynecol. 2008 May-Jun; 15(3): 286-91. RIGHT: Poston RS, et al. Comparison of economic and patient outcomes with minimally
invasive versus traditional off-pump coronary artery bypass grafting techniques. Ann Surg. 2008
Complications
Major & minor complications in prostatectomy (LEFT): da Vinci: Bhandari A, et al. Perioperative complications of robotic radical prostatectomy after the learning
curve. J Urol. 174, 915-918. Open: Brown, J.A., et al. Perioperative morbidity of laparoscopic radical prostatectomy compared with open radical retropubic
prostatectomy. Urologic Oncology. 2004; 22, 102-106. Lap: Guillonneau B, et al. Perioperative complications of laparoscopic radical prostatectomy: the Montsouris
3-year experience. The Journal of Urology. 2002; 167, 51-56. In hysterectomy (RIGHT): Boggess JF, et al. A comparative study of three surgical methods for
hysterectomy with staging for endometrial cancer: robotic assistance, laparoscopy, laparotomy. Am Jrnl of Obst & Gyn. Oct 2008; 360. e1-360e9
Conversions
OR Time (LEFT) and Conversion rate (RIGHT): Payne TN, Dauterive F. A comparison of total laparoscopic hysterectomy to robotically
assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive Gynecol. 2008 May-Jun; 15(3): 286-91.
Overcoming Capacity
Constraints
Overcoming Capacity Constraints
In this Section
• Shorter length of stay
(LOS)
• Faster OR turnover
time
• Maximizing cases per
day through OR
efficiency
Conclusion
da Vinci Surgery has a proven
ability to reduce length of stay
across multiple specialties and
to match and surpass existing
efficiency benchmarks as
surgeons and OR staff become
proficient with the system.
Length of Stay
Hysterectomy (All): Customer proprietary data, hysterectomy admission trends, community hospital. Reference ISI internal document, 871875. Prostatectomy
(open): Dahl DM, et al. Laparoscopic radical prostatectomy: initial 70 cases at a U.S. university medical center. Urology. 2002 Nov;60(5):859-63. Prostatectomy (da
Vinci): Bhandari A, et al. Perioperative complications of robotic radical prostatectomy after the learning curve. J Urol. 174, 915-918 Hysterectomy (benign): Payne
TN, Dauterive F. A comparison of total laparoscopic hysterectomy to robotically assisted hysterectomy: surgical outcomes in a community practice. J Minim Invasive
Gynecol. 2008 May-Jun; 15(3): 286-91
OR Turnover and Efficiency
Customer proprietary data
OR Turnover and Efficiency
Customer proprietary data
Physician Hospital Relations
Physician Hospital Relations
In this Section
• Attracting innovative
surgeons
• Surgical residency and
fellowship program
adoption of da Vinci
• Inclusion in national
surgical society
curriculum
Conclusion
da Vinci Surgery programs have
demonstrated the ability to
attract skilled and innovative
surgeons, which will become
increasingly significant given
the prevalence of da Vinci
Systems at hospitals with
residency and fellowship
programs.
Physician Hospital Relations
Adopting New Technology
Adopting New Technology
In This Section
• Best practices
• Tools for success
Conclusion
A commitment to implementing a
da Vinci Surgery program by taking
full advantage of a strong
partnership with Intuitive Surgical,
is the fastest path to success.
Adopting New Technology
Six best practices fundamental to building a highly successful da
Vinci Surgery program:
HOSPITAL:
1) Manage da Vinci Surgery as a key
program
2) Coordinate operations
3) Actively market the da Vinci program
SURGEON:
1) Create a vision for your da Vinci practice
2) Follow the prescribed clinical pathway
3) Actively market your practice
Tools for Success
• Robotic Surgery Program Implementation
Whitepaper
• da Vinci Surgery Marketing Toolkit
• 24/7, 365 days per year customer service
• Reimbursement and Coding information hotline
• da Vinci Surgery OR Efficiency Guide
• da Vinci OR Specialist Program
Summary of da Vinci Program Benefits
Challenge
1) Improving Patient Outcomes &
Satisfaction
2) Safety and Quality of Care
3) Attracting Patients
4) Overcoming Capacity Constraints
5) Physician Hospital Relations
6) Adopting New Technology
Solution