Becker's Spine Review

36 ASC Next-gen spine robots are targeting ASCs By Alan Condon T wo of the biggest drawbacks of spine surgical robots are their size and cost, but the next generation of robots are addressing these challenges to encourage their adoption at ASCs. Most surgery centers don't have the budget to install a spine robot, which increases the cost per procedure with- out bringing in higher reimbursement from insurers. Many ASCs also operate on fine margins, and as spine ro- bots offer minimal value to experienced surgeons, they are considered cost prohibitive in surgery centers. Some hospitals and health systems are willing to invest in spine robots — which cost about $1 million — to attract surgeons and patients to their spine centers, but the pace of outpatient migration has smaller hospitals thinking twice about such an expensive capital cost. "I approached a hospital in Las Vegas about purchasing a robot to perform minimally invasive spine surgery and increase volume at that hospital," Vladimir Sinkov, MD, of Las Vegas-based Sinkov Spine Center told Becker's. "But they expect to lose so many elective spine surgery cases over the next five years to ASCs and expect very little cases to be done in the hospital, so they didn't want to invest in the technology." ASCs don't have the resources or capital to fork out a million dollars on a robot when the surgeries can be per- formed without them, so device companies are now devel- oping robots with this in mind. Accelus, formed through the merger of Integrity Implants and Fusion Robotics last year, has developed the Remi robotic navigation system to assist surgeons during spine cases and address the cost barriers ubiquitous with cur- rent robotic technology. Remi was designed to address the "significant limitations associated with those legacy systems, such as extended setup and teardown time, procedural workflow disrup- tions, large footprints and high cost," said Kevin Foley, MD, neurosurgeon and chief robotics officer at Accelus. "Remi addresses all of these concerns, providing equiva- lent accuracy with an optimized procedural workflow and duration at a fraction of the cost of previous systems." While newer device companies focus on bringing their spine robots to market, other companies are developing new business models to help sell or lease their robots to ASCs, which, if they are physician-owned, are more delib- erate when it comes to upfront capital costs. "It's all about efficiency, outcomes and where patients want to go as well as what they're having done," Martin Roche, MD, director of hip and knee arthroplasty at HSS Florida in West Palm Beach, told Becker's. "[Device com- panies] may link it to how many cases you do, which can help pay it down, and develop various 'at risk' models." n 22-physician orthopedic group to build $18.7M ASC By Alan Condon T he Center for Sports Medicine and Orthopaedics has begun building an $18.7 million surgery center in Ty- ler, Tenn., the Chattanooga Times Free Press reported May 24. The 37,500-square-foot ASC will replace the 22-physician orthopedic group's surgical facilities in downtown Chatta- nooga. It will feature eight operating rooms, two procedure rooms and 40 preoperative and recovery bays. "We are thrilled to break ground on our new surgery center, which we anticipate will be a destination for orthopedics in our region," said Benjamin Miller, MD, medical director for the group's ASC. "We made the decision to pursue the new ambulatory surgery center to expand our footprint and be a leader — both in our community and across the country — for innovative outpatient orthopedic surgical care." About 75 to 80 people, including up to 21 physicians, are expected to staff the ASC, according to the report. It is ex- pected to open in summer 2023. n UC Davis to build $579M outpatient surgery center By Marissa Plescia U C Davis (Calif.) Health is planning a $579 million outpatient surgery center at its Sacramento, Calif., campus, which it expects to build by 2025, The Sac- ramento Bee reported June 2. The project is part of a major expansion plan that includes a rehabilitation hospital and a $3.8 billion patient tower. It is also creating a multibillion-dollar innovation hub, ac- cording to the report. The surgery center will have 12 major operating rooms, five minor procedure rooms and several imaging rooms. UC Davis said in a report to UC regents that the surgery center will allow them to transfer all outpatient procedures out of the medical center, according to the Bee. The current spaces "are insufficient and lack the necessary beds and space to house complex outpatient surgeries that require overnight patient recovery and large, modern operating suites to accommodate advanced technolo- gies," UC Davis leaders said in their report, according to the Bee. UC Davis expects to take on $300 million in debt for the project. n

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