A rather large wave of opportunity is about to arrive for perioperative oncology nurses working in or wanting to learn robotic surgery. The market for robot-assisted minimally invasive surgery (MIS) for prostatectomy, hysterectomy, and other cancer procedures is booming as more hospitals and clinics purchase surgical robots and begin training their surgical teams to operate them. Add to this growth, the impending arrival of new surgical robot manufacturers to compete with the predominate da Vinci Surgical System, and thousands of new positions for perioperative nurses certified in robotics could soon be created.
“In the very near future robotics is simply going to be the way surgeries are performed, and for nurses looking to align their perioperative careers with the future, training for robotic surgery is paramount,” said Marci Trump, surgical robotics coordinator at Long Beach Memorial (LBM) Hospital in Long Beach, California.
Already 4 out of 5 radical prostatectomies in the United States are performed using the da Vinci system from Intuitive Surgical (Sunnyvale, California).1 In a market that is expected to grow from $3.2 billion in 2012 to $20 billion in 2019, as many as 3,000 US hospitals and 5,000 private outpatient surgical clinics are without robotic surgery programs.2,3
Nurses are trained in robotic surgery by their hospitals, and for the last 15 years that training was on the da Vinci system, the only FDA-approved robotic surgical system to date.4 However, its $1.5 million price tag has prohibited many hospitals and clinics from purchasing one and starting their own robotic surgery program, which requires at least two robotic surgery procedures per day to offset the cost of the system.
But the Single Port Orifice Robotic Technology (SPORT) Surgical System, a $700,000 robotic surgical system from Titan Medical (Toronto, Canada), can lower the barrier of entry for hospitals wanting to offer robotic surgical procedures.5 Titan told Oncology Nurse Advisor that the company is excited about the fact that the arrival of SPORT in the United States will create new opportunities for greater team work and collaboration between perioperative nurses and surgeons. SPORT is expected to earn FDA approval in 2015.
A third player in the robotic MIS market, Medrobotics Corporation (Rayham, Massachusetts), maker of the Flex Robotic System, is moving rapidly toward FDA approval to begin marketing its surgical robots in the United States.6 Robots from Titan and Medrobotics are similar to da Vinci in the way they perform MIS, and each have fewer robotic arms than da Vinci. All three manufacturers’ robotic surgical systems require at least two nurses certified in the respective robotic surgery system to assist in surgeries.
Trump remembers being one of the first nurses to raise her hand and get onboard LBM’s da Vinci program when it began 5 years ago. Nurses have a great deal of influence when it comes to a hospital’s decision to invest in a robotics program, and having the nurses onboard with a hospital’s decision to begin a robotics program is essential to its success, said Wiley Nifong, MD, associate professor of Cardiothoracic Surgery at the East Carolina Heart Institute, who trains cardiac surgical teams on the da Vinci. Nurses tapped for robotic surgery who take a vested interest in their hospitals’ robotics program early on are the ones typically groomed for management roles, such as Robotics Coordinator or Services Coordinator, depending on how a particular hospital assigns its positions. In these management roles nurses, oversee multiple robotic surgical teams and work with the manufacturer to maintain the instruments and perform ongoing peer-to-peer training, he said.
When LBM added a second da Vinci system, Trump became the robotics coordinator for Urology and General Colorectal Robotics at LBM. In December, she became the robotics coordinator for gynecologic surgery. “I was totally unprepared when I first saw a robotic system,” she said. “They are amazing.”