Surgical Robotics Adoption

Recently-retired interventional cardiologist at a major US academic medical centre

Topic
Surgical Robotics Adoption
Industries
HEALTHCARE & LIFE SCIENCES
Published
07 Mar 2026
Length
2,564 words
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Recently-retired interventional cardiologist at a major US academic medical centre

Analyst: You retired at the end of last year. In your last full year, how much of your lab's volume actually went through the robot?

Expert: Not much. Hundred and eighteen cases. Sorry, hundred and eighteen was the year before that. Last full year we did a hundred and thirty-one. And our total PCI volume was eleven forty-something across four labs, so you're at eleven and a bit percent. Eleven point four, if you want to be precise about a number I'm recalling from memory. Seven years after we bought the thing.

Analyst: Eleven percent. The vendor material I've read talks about robotic-eligible fractions in the thirties.

Expert: Of course it does. That's a morphology number. Somebody sits with a stack of angiograms and asks whether the anatomy could be done robotically. Respectable enough as an academic exercise. Almost nothing to do with a Tuesday.

Analyst: So what happens on a Tuesday?

Expert: Primaries are gone immediately. You're not walking a STEMI into the one room with the robot in it and booting up. Nobody has that debate twice. Then your add-ons, somebody comes off the floor at two in the afternoon with a climbing troponin, he goes to whichever room is free, and the robot's in one of four. Then anything needing real guide support. Heavy calcium, your CTOs, anything where you already know you'll end up leaning on the catheter with your own two hands. What you've got left is elective, decent anatomy, ideally one vessel, booked ahead, in Room Three, on a day somebody credentialed is around. Apply all of those and not just the first one and you're at twelve, thirteen. Which is where we landed and stayed.

Analyst: And the procedure-time penalty. Real, or the learning-curve artifact they describe it as?

Expert: It got smaller. Never went away. First twenty-odd cases I was adding half an hour door to door, maybe more. By case a hundred I was at nine, ten minutes on a clean one, because our lab manager tracked room turnover to the minute and I wanted the ammunition. It never went to zero and I don't believe it does for anyone. Setup, the cassette load, and most cases you break off at some point and do a bit by hand anyway.

Analyst: How often did you convert to manual?

Expert: First year, about a fifth. Settled around nine. That nine I'd defend.

Analyst: Okay. Let's do the capital.

Expert: Million and a half at the bottom. Two and a half if you take the full configuration and they don't want the logo badly enough to discount. Service is another hundred, hundred and eighty a year once you're out of warranty. But capital was the easy part. You argue about capital once. Ours went through committee in about forty minutes, nine people in the room, our division chief did most of the talking, done. And nobody in that room asked the question that actually mattered.

Analyst: Which was?

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02.1 — What's in the full transcript

The rest of the call goes through the per-case cost stack, including cassette price, a room-time allocation they admit they don't fully trust, and the missing payment code. Plus the acquirer's capital bundling and what it does to installed-base counts, two outages and the utilisation they never recovered, why they now rate stroke over coronary, and the two calls they got wrong.

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