• José Gregorio Pereira-Arias, Mikel Gamarra-Quintanilla, Andrea Sánchez-Vázquez, Jorge Alberto Mora-Christian, Luis Felipe Urdaneta-Salegui, Ander Astobieta-Odriozola, and Gaspar Ibarluzea-González.
• Urología Clínica Bilbao SL. Clínica IMQ Zorrotzaurre. Bilbao. Bizkaia. España.
• Arch. Esp. Urol. 2019 Apr 1; 72 (3): 227-238.

ObjectiveAdvancements in the robotic surgical technology have revolutionized the standard of care for many surgical procedures. The purpose of this review is to focus on the different issues involved in developmental phase of starting a robotic program and to evaluate the important considerations in developing this program at a given healthcare institution.Methods & ResultsAlthough every hospital might desire a robotic program, there are many requirements needed to uphold a successful and self-sustainable program in the current healthcare market. Patients' interest in robotic-assisted surgery has and continues to grow because of improved outcomes and decreased periods of hospitalization. Resulting market forces have created a solid foundation for the implementation of robotic surgery into surgical practice. A thorough market analysis, including that of competing entities and estimated surgical volume, is necessary prior to purchasing a robot. Another issue to be addressed is determining whether one has trained surgeons or the capability to recruit the appropriately trained surgeons to keep a robotics program afloat. Formally trained robotic surgeons have better patient outcomes and shorter operative times. An assessment of facilities and staff is also imperative prior to making such a substantial investment. Ultimately, after a well thought-out analysis, a decision must be made as to whether the institution can support and maintain a robotics program.ConclusionsIndividual economic factors of local healthcare settings must be evaluated when planning for a new robotics program. The high cost of the robotic surgical platform is best offset with a large surgical volumen,interdisciplinary utilization of the technology may be the solution. A mature, experienced surgeon is integral to the success of a new robotics program. Define procedures to be performed, necessary training, staff involved,equipment, facilities, setting-up, economical resources and marketing are important issues to be teaken into account before acquiring a surgical robotic system.

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