Before ASC leaders decide to use capital on a robotic-assisted joint replacement platform, they may want to ask who actually benefits.
Hafiz Kassam, MD, director of the shoulder reconstruction division of Hoag Orthopedic Institute in Irvine, Calif., said the technology may not move the needle for high-volume surgeons like himself — and space and cost constraints may keep robots out of ASCs for now, in favor of cheaper, lower-footprint tools like mixed reality
Earlier this year, Dr. Kassam became one of the first surgeons to use Zimmer Biomet’s ROSA robotic system for shoulder replacement.
Dr. Kassam recently connected with Becker’s to discuss where robotic assistance actually adds value, why ASCs may lean toward other enabling technology instead of robots in the near term, and what he thinks the industry should be optimizing for.
Editor’s note: Responses have been lightly edited for length and clarity.
Question: How will this technology impact high-volume surgeons vs. lower-volume surgeons?
Dr. Hafiz Kassam: I think the real value is that most shoulder replacements in this country are done by surgeons who do far fewer cases a year, with some studies putting it under 50 cases. The question is if technology can bring the outcomes of a surgeon who does 20 surgeries a year closer to one who does 80 or 90 surgeries? I don’t think it’s going to make someone doing 350 a year significantly better, outside of reducing outliers a bit. But raising the baseline for surgeons who don’t operate as often, especially in smaller communities, is probably where the real value shakes out.
Q: How do you see robotics fitting into the broader shift toward ASCs and outpatient joint replacement?
HK: I’m not sure robots will necessarily make patients recover faster. I think it comes down to the availability of technology. Robots take up space and carry real capital costs, and ASCs are limited on both fronts. I think, at least in the midterm, ASCs will lean toward enabling tech like mixed reality, while hospitals hold onto the robots. There may be some crossover eventually, but site differentiation is likely for the next several years just because of space and cost.
Q: What’s the most important thing for ASC and hospital leaders to understand about this technology right now?
HK: This is really the beginning of this technology, and it’s exciting to be at the front of it. But I’m less interested in using a robot because it’s novel and more interested in whether we can develop technology that helps the profession more broadly — whether that’s helping surgeons who don’t operate as often, or improving access for patients in communities without high-volume surgeons. That’s the question leaders in this space should be focused on, rather than adopting a robot just because it’s the newest thing.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
