Purchase of a Da Vinci Robotic Surgical System, and related maintenance and consumables

Description

The HSE, on behalf of University Hospital Waterford (UHW), intends to purchase a Da Vinci Robotic surgical system from Intuitive Surgical.This surgical system will be used to undertake minimally invasive surgery at UHW, which is a recognised centre of excellence for cancer care within the South East region. Lot 1: The HSE intends to make the above purchase of a Robotic Surgical system from Intuitive Surgical because they are the sole supplier of this system. The robotic programme will enabled the Surgery department to vastly increase the number of surgeries performed by a minimally invasive approach, and thus reduce the number of laparotomies undertaken. Further procedures in University Hospital Waterford may also be conducted with this robot over time.The robot enables more complex cases to be safely undertaken by a minimally invasive approach, such as complex surgical operations and complex patients. This will continue to give clinical and patient benefits leading to shorter hospital stays for patients, faster recovery with fewer complications. This purchase will include all proprietary consumables required for procedures, as well as maintenance and training. Following extensive research of the marketplace, no other supplier of this system has been identified that can provide all of the required aspects of the system including supply, maintenance and training. These products and services can only be provided by this particular provider, and competition is therefore absent for technical reasons due to the unique essential features of the equipment required. Intuitive Surgical is currently the only manufacturer of commercially available robotic assisted surgical systems offering robotic four-arm multi port technology and a suite of fully wristed instrumentation, wristed advanced energy and stapling instruments, fluorescence imaging, integrated table e surgical procedures. Advanced energy device / Vessel sealing capability: This is essential to safely divide areas with blood vessels including the mesentery for any colectomy (right colectomy, left colectomy, anterior resection) as well as for urology (pyeloplasty, nephrectomy, cystectomy) and gynaecology (hysterectomy, salpingo-oopherectomy). Other robotic platforms do not have this feature and surgeons using other robots are required to convert each procedure to laparoscopy and use laparoscopic equipment and energy devices to complete their dissections – this increases cost, prolongs operative time and negates many of the benefits of robotic surgery. Stapling devices: For any colorectal resection (right colectomy, left colectomy, anterior resection), stapling devices are essential to divide the bowel and perform anastomosis inside the abdomen (intracorporeal). Again, surgeons using other robots are required to convert the procedure to use open or laparoscopic staplers to complete these operations which prolongs operative time and negates many of the benefits of robotic surgery. Table motion: Colorectal surgery involves operating in all 4 quadrants of the abdominal cavity. The ability to move the table and robot together simultaneously without undocking and re-docking the robot greatly facilitates the ability to operate in multiple quadrants for extended resections (extended left and right colectomy, low anterior resections) and complete complex operations in a minimally invasive manner. Firefly near-infrared fluorescence imaging: Using indocyanine green dye to examine bowel blood flow with NIR fluorescence is standard of care in our institution when joining bowel segments back together following left & right colectomies and anterior resections. The daVinci Xi is the only robot capable of utilizing this technology. At this point in time, the HSE believes that there are no other medical robots available that can fully meet the above surgical requirements, skills simulation all on a single platform, capable of performing minimally invasive procedures on patients. Unless any notification received by a supplier stating there exists available on the market a competing product with equivalent performance with 21 days, the HSE intends to proceed and then publish a contract notice on conclusion of negotiations without going to tender on the basis of article 32 of the EU Directive 2014/24