A report from LEERINK, a stock market analyst, relates a conversation with a general surgeon who does 150 daVinci robot surgical cases per year. (Sorry, no link available.) An excerpt:
The surgeon has noticed a significant recent effort from ISRG to push robotic use in hernia as a way to target general surgeons. For him, the case for adoption is stronger in more complex ventral cases vs. inguinal hernias, but he still thinks the economic/clinical rationale is tenuous for both. In his view, robotics' penetration in hernia is unlikely to go above 5% (up from <1% today), and he has yet to find a hernia procedure that is "ideal for da Vinci."
Well, economic and clinical rational has never mattered before. Will the profession ever put a stop to this supply-push form of medical equipment sales?
The surgeon has noticed a significant recent effort from ISRG to push robotic use in hernia as a way to target general surgeons. For him, the case for adoption is stronger in more complex ventral cases vs. inguinal hernias, but he still thinks the economic/clinical rationale is tenuous for both. In his view, robotics' penetration in hernia is unlikely to go above 5% (up from <1% today), and he has yet to find a hernia procedure that is "ideal for da Vinci."
Well, economic and clinical rational has never mattered before. Will the profession ever put a stop to this supply-push form of medical equipment sales?
As the president of the Americas Hernia Society at our meeting this year, I did meet with their company and proposed that they measure the value to the patient for using the robot for laparoscopic ventral hernia repair. They were not interested. It seems they will still persist with the 20th century model of pushing volume. Measuring value for the entire cycle of care for the patient is our 21st century healthcare challenge. The companies that do that will be much more likely to have long-term sustainability, I believe.
ReplyDeleteOnce again, as right from my very first personal assessment of the device back in 2007, a solution looking for a problem. Or perhaps more accurately, a very expensive (and potentially dangerous) marketing tool.
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