Louisville Medicine Volume 63, Issue 5 | Page 29

orations and provided a more robust means for accountability in health care. In another regard, one of most tangible impacts of technology can be felt in the operating room. Complicated open surgeries that once led to disfigurement, massive blood and/or functional loss, and increased likelihood of infection and death have been effectively replaced by minimally invasive surgeries that mitigate such shortcomings. Surgeons have expressed appreciation for modern approaches as they enhance vision, dexterity, precision, and access. To patients, the prospect of returning to a normal life is equally as cherished. Yet, a key question is not whether modern surgical approaches are beneficial, but rather if the degree to which they are implemented is truly warranted. In addition to having a steep-learning curve and high costs of acquisition and maintenance, surgical systems such as da Vinci® significantly increase total operating time and are often incompatible with existing protocols and tools in the OR7,8. Further, such technologies are driving up the cost of health care in general9. As smaller hospitals and clinics buy more advanced systems to compete with larger centers, the need to push their utilization grows proportionally as reimbursement rates fall10. A procedure that could be sufficiently accomplished via open or conventional laparoscopic approaches may instead be performed robotically to enhance a hospital’s return on investment, even though long-term outcomes between robotic and cheaper, conventional laparoscopic cases remain comparable11,12. Here, physicians should give important consideration as to whether a procedure absolutely requires the latest, more expensive tools to deliver a desired outcome. )%