A Yale Robotic Surgery Symposium held in the spring was the perfect time to celebrate Yale New Haven Health’s milestone of more than 30,000 robotic-assisted cases completed across the health system, yet the symposium also gave experts an opportunity to forecast a far greater role for robotics in the future.
Experts agreed that patients will continue to benefit from robotics in urology and gynecology while they predict significant growth in general surgery, with many laparoscopic and open procedures soon to be performed robotically.
That seismic shift in coming years also likely means a future of enhanced safety, improved outcomes and shorter lengths of stay for patients, and it could mean significant savings for health systems that embrace the technological advances.
“The combination of robotics and artificial intelligence will give us incredible opportunities that we haven’t seen before,” predicted Mani Menon, MD, chief of strategy and innovation in the urology department for the Mount Sinai Health System in New York. Menon, the event’s keynote speaker, is known for his pioneering work in cancer surgery that helped build the foundation for modern robotic surgery.
Menon, however, had one caveat. “Without a human being behind the controls, you can’t really put all the pieces together,” he said. “You need human beings trained to use these amazing technologies, and (Yale New Haven Health) has the human capital.”
Andrew J. Duffy, MD, associate surgical chief of digestive health for YNHHS, director of the YNHHS Hernia Program and associate professor of surgery with Yale School of Medicine, co-directed the symposium along with Department of Urology Chair Isaac Y. Kim, MD, PhD, MBA, and Professor of Obstetrics and Gynecology and Clinical Director of Gynecologic Oncology Elena Ratner, MD, MBA. Duffy said there is the likelihood of unprecedented robotic advances in general surgery.
“We’re just entering that exponential growth. Surgeons are adopting robotics because of improved patient outcomes, the ability to do procedures with higher quality, and faster recovery for patients,” he said. “There’s also an ergonomic benefit for the surgeons. Surgeons get a lot of injuries – neck, spine and joint problems – and robotic ergonomics should be decreasing that.”
Another boon for robotics is data, Duffy said. “For every patient case, robotic equipment collects data that can be analyzed, individually or collectively, to find the best way of doing something,” he said. “This is where artificial intelligence comes in. That’s what’s going to be the biggest difference in the next five or 10 years – how we use data to make our practices better and to make our outcomes better.”
Christopher O’Connor, CEO of YNHHS, and Nancy Brown, MD, dean of the Yale School of Medicine, both gave remarks at the symposium. O’Connor said that, together, YNHHS and Yale Medicine are collaborating to develop a joint strategic plan to become one of the nation’s premier academic health systems. As part of that plan, O’Connor said, “We are committed to driving surgical innovation through robotics and using industry-leading technologies. The most advanced and versatile da Vinci systems are deployed at every hospital, supporting our surgical expertise in a variety of specialties.”
Joseph Renzulli, MD, director of urology for the eastern region of Yale New Haven Health and an associate professor of urology with the Yale School of Medicine, said robotics can help improve access to services while generating savings. For example, Renzulli noted that there were 4,238 da Vinci robotic cases performed across the health system in 2023, with an average length of stay (LOS) of 1.5 days, compared with the average LOS of six days for open surgeries during the same time, and better than 1.9 days for laparoscopic surgeries.
“In the future, converting a percentage of open cases to robotics could reduce surgical times, enable more cases to be done each day, reduce complications such as blood loss and surgical site infections, reduce LOS, increase patient access, and decompress hospital inpatient populations,” Renzulli said. “When it comes to opportunities for savings, the numbers are staggering.”
As an example of robotics enhancing a specific type of surgery, Stephanie Joyce, MD, chair of trauma surgery at L+M Hospital, said robots are “revolutionizing” complex hernia repairs. “We’re expanding access to our robots for more and more cases, on nights and weekends,” Joyce said. “The future of robotics will be 24-hour access at all our locations.”