An Investigation of the Technical, Social, and Financial Limitations on the Implementation of Robotic Surgical Technology

Abstract

The advent of laparoscopy was a revolution in surgery that had large impacts on patient experience. Small incisions healed more quickly, less blood was lost, and time in the hospital was shortened without loss of precision. The mechanics can be awkward for the surgeon, however, and hope remained for something more ergonomic. The answer seemed to come in the late-1990s when surgical robots entered the picture. The field of new robots was quickly narrowed down to Intuitive Surgical’s da Vinci robot through a series of strategic buyouts, and da Vinci gained FDA approval for abdominal laparoscopy in 2000. It remained the only approved device in that category until 2017. Since that time, robotic surgical system use and implementation has been shaped by three main factors: the regulatory process, the financial barriers to acquiring and maintaining a robot, and public perception from both clinicians and patients. The purpose of this study is to review and discuss the ways in which these factors influence the use, availability, and development of robot-assisted surgery.