These machines also come with challenges that must be balanced against the improvements they offer. Chief among these is the high cost of the core robotic system itself. The large units typically run from $1.5 to $2 million each. Investing this kind of capital requires a hospital to analyze its surgical volume to determine whether an ROI case can be made for the purchase. Once purchased many of these machines require significant floor space to install and operate. In a few cases, the OR must be custom configured and dedicated to a single robot. Each robot also requires its own unique surgical instruments. These may be reusable, single-use, or multi-use disposables. The disposable items can increase the cost per case of a procedure by $200 per instrument or more, another case for re-calculating profit margins. Then there is the cost of training staff at all levels to work with the new robot and its instruments. This begins with the surgeons but extends to the nurses and assistants who work side-by-side with the machine, and even to the sterile processing staff who must clean and store these unique instruments following the surgery.

Though the challenges are not trivial, the advantages continue to attract healthcare systems to adopt these devices and investors to fund companies with clever ideas for new robots. Today’s robots have a very small footprint with the IT infrastructure of a hospital since they are generally closed systems which, at most, use hospital networks only to exchange system diagnostic data with the manufacturers. But as future systems become smarter they will become a more integrated and demanding part of the healthcare IT ecosystem. This may include integration with the hospital EHR systems and imagery databases, and connections to external cloud-based AI services which are able to provide surgeon guidance and advice in real-time. Each of these connections will raise new questions about access to patient data and exposure of internal hospital information to vendor computers.

Today, surgical robots sound futuristic to most people, even though they have been in active use for almost two decades. The future holds more robotic devices that can provide better assistance to human surgical teams by extending and enhancing both the physical and the mental capabilities of clinicians. The future of healthcare will have more humans and more robots working together throughout the continuum of care for our aging population.