Disposal+&+End-of-Life

Robotic surgery is a relatively new form of technology in modern medicine. Intuitive Surgical, Incorporated, formerly known as SRI and based in Sunnyvale, California, manufactures the da Vinci Surgical Robotic Systems. Intuitive’s first archetype system was developed in the late 1980s while under contract with the U.S. Army. Albeit its preliminary funding was for the purpose of developing a mechanism that could perform surgeries in a combat zone remotely, Intuitive, foresaw the industrial applications of its da Vinci system. To the medical industry, the application would be towards minimally invasive surgeries.

To aid in this article, studies were made via face-to-face and telephone interviews of administrative and medical personnel of John Muir Medical Center located in Walnut Creek, California. John Muir’s Walnut Creek Center was ranked by U.S. News and World Report as one of America’s best hospitals in 2009-2010. John Muir Medical Center is the first in Northern California to obtain two sophisticated da Vinci Surgical Robotic Systems. In order to acquire further information, telephone interviews were also made with Intuitive Surgical, Inc., combined with that of web-based research.

The robotic surgical systems are fairly new in the market as the first da Vinci system was introduced in 1999. David Fernandez, John Muir’s Hospital Administrator, says that their da Vinci systems have only been in service for less than a year. Mr. Fernandez states that since these systems are the latest in advanced technology, it will be years, if not decades, before John Muir would have to cogitate about its disposal. In the interim, the da Vinci systems would most likely receive mechanical upgrades and user-interface updates as part of its maintenance package.

According to Alexis Morgan, Customer Liaison at Intuitive Surgical, Inc., Intuitive’s Robotic Surgical Systems cost $1.0M for the da Vinci S version, while the latest Si model costs $2.3M. The maintenance and service agreements for the da Vinci systems range from $100K to $180K per annum, depending on the model. There are currently 1,395 da Vinci systems installed throughout the world, with 1,028 of those in the U.S., and 67 in Asia.

Although the medical industry has evolved dramatically in large part because of the advent of computers and robotics, the proper disposal of medical equipment is an important subject matter. Danielle Locassio, Head Surgical Coordinator at John Muir – Walnut Creek, says that their center has a low-turnaround with their medical equipment and apparatus. Most are retrofitted, or upgraded in order to cut down on costs and to help with the environment. Ms. Morgan, at Intuitive, adds that most of their equipment are refurbished, while the rest of the disposable parts, such as plastic and metal components are recycled and reused. Ms. Locassio also explained that most hospitals do not sell their outdated machines because of liability issues, but that some of their antediluvian equipment are donated either to local medical schools or to third world countries such as Mexico, Indonesia, Philippines, etc.; depending on need. However, Ms. Locassio concedes that it will be a while before their da Vinci Robotic Surgical Systems become antiquated since they are the most advanced equipment they have installed.

In general, although medical technology has progressed significantly in recent years, so has the medical industry’s responsibility and consciousness of its environmental impact. Robotic surgical machines are contemporary advancements and their quality and durability will indubitably be first-rate and, therefore, built to last for eons. These robots are also backed by high-tech, albeit costly, maintenance and service programs, which only ensure their longevity. The increased environmental awareness of the industry and society helps ensure that these robotic equipments are going to be refurbished, retrofitted, reused, or recycled – the four, not three, “Rs” – in the years to come.

//**Note:** Arky Agoncillo, one of our groupmates based in San Francisco, interviewed the ff. doctors there at the two hospitals mentioned:

Danielle Locassio, Head Surgical Coordinator, John Muir Medical Center – Walnut Creek David Fernandez, Hospital Administrator, John Muir Medical Center – Walnut Creek Alexis Morgan, Customer Liaison, Intuitive Surgical, Incorporated Honora Bausano, Customer Liaison, Intuitive Surgical, Incorporated//