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House of Assembly - Fifty-Second Parliament, Second Session (52-2)
2012-05-31 Daily Xml
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DA VINCI SURGICAL ROBOT

The Hon. R.B. SUCH (Fisher) (14:11): My question is to the Minister for Health and Ageing. Can the minister inform the house of a possible replacement for the Da Vinci robot at the Royal Adelaide Hospital?

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (14:11): I thank the member for Fisher for his question and I acknowledge his abiding interest in the Da Vinci robot technology used at the Royal Adelaide Hospital.

The Hon. R.B. Such: It saved my life.

The Hon. J.D. HILL: It saved his life, he says. I advise the house that the current Da Vinci robot was donated to the state by the Pickard Foundation in 2004.

The Hon. P.F. Conlon: A great man.

The Hon. J.D. HILL: As my colleague the Minister for Transport and Infrastructure said, a great man. This robotic platform offers a minimally invasive option for major surgery and is an alternative to other laparoscopic techniques or open operations. It was initially planned to use the robot for cardiac and urological surgery. However, cardiac surgeons decided it was not of significant assistance to them in improving patient outcomes. It was taken up by urological surgeons and I am advised that more than 2,000 cases have been performed, with excellent outcomes. I am also advised that radical prostatectomies are performed as 23-hour cases, so almost day surgery, which is the point the member for Fisher made to me when he was talking about this at some other time.

The machine has also been used for gynaecological and laryngeal procedures, proving to be an effective way of reducing length of stay and, in the case of ear, nose and throat surgery, reducing the need for tracheostomy and post-operative care in the intensive care unit. In total, the machine has been used to perform more than 3,000 major procedures. That is the good news. The difficulty is that the company that manufactures the robot is phasing out the model in operation at the RAH and will be unable to support the current machine beyond 2013.

Currently, a significant proportion of patients treated by the robot are privately insured because no such machine exists in the private sector. So, the Royal Adelaide Hospital is supporting a machine which is used quite substantially by the private sector as well as the public sector. I am told that the replacement cost for a new Da Vinci robot would be more than $3 million, and that there is an annual $300,000 maintenance cost. So, it is quite an expensive machine. Individual costs are quite high too. The machine costs about $6,000 in consumables for every time it is used, so it is a very expensive option.

What we have to do in assessing whether or not and what kind of technology will be used to replace the existing machine is to do a cost-benefit analysis. It is true it means that patients will spend less time in hospital, but the capital cost of delivering the service to them is much greater. So, we will go through this analysis over the next little while. One option worth exploring is whether the private sector might take a machine on and then public patients could gain access to it at various times.

We will need to look at it and all of the other available technologies which might be used to replace it. I do not want to be a complete wet blanket, but it is a very expensive bit of technology. It was given to the state free of charge so we did not have that capital cost. We did have high maintenance costs. It has been a very effective bit of technology, and the member for Fisher can attest to that, but we will go through a proper assessment of it, I can assure him of that.

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