Launching a Successful Robotic Program

Open radical prostatectomy remains the gold standard for management of organ-confined prostate cancer. However, recently there has been a trend toward the search and development of less invasive surgical options. Robotic-assisted laparoscopic prostatectomy (RALP) is rapidly becoming the most commonly performed surgical approach to treat these tumors. The most commonly used robot is the da Vinci® Surgical System (Intuitive Surgical, Sunnyvale, CA), which provides advantages like three-dimensional (3-D) vision, 10× magnification, motion scaling, and tremor filtration, allowing the surgeon a more feasible learning curve. In spite of the substantial benefits of robotic surgery (RS) over standard laparoscopy, performing robotic surgery still requires for the surgeon to undergo a necessary learning curve (LC), in order to ensure the safe introduction of this technology. In this setting the adoption of RS at any institution requires the establishment of a well-structured plan and certain key elements to be in place to ensure successful implementation of a robotics program. A thorough initial design and implementation lead to the execution of clinical services, which meet previously established goals. Once the execution phase is established, the next step is to focus on maintenance and growth to maximize the benefits of the program. In this chapter, we discuss the necessary phases for creating a successful robotic program, paying special attention to the aspects that allowed our facility to create a profitable robotic-assisted laparoscopic prostatectomy program.