Case Study: Pacifica Salud initiates their robotic-assisted surgery program with Hugo™ RAS System

Located in Panama, Pacifica Salud is ranked in the top three hospitals in Central America. It is the first hospital in Latin America and the Caribbean to be affiliated with Johns Hopkins Medicine International, and is the only hospital in Panama ranked among the 50 best hospitals in Latin America by América Economica. It offers a comprehensive range of healthcare services with over 250 clinicians and 74 patient rooms.

Vision and goals

Already known as a world-class hospital, Pacifica Salud aspires to be a hospital of reference in Latin America, providing high standards of care, contributing to knowledge creation and continuously developing human talent. Adding a surgical robotics program was central to achieving their goals and attracting top surgical talent practicing robotic-assisted surgery (RAS) at other institutions.

Robotic program background

In 2017, Pacifica Salud offered several state-of-the-art technologies, but they did not yet have a surgical robot. Many of their surgeons had been practicing RAS and were highly skilled at using robotic technology, ~65% of all procedures in Panama are still performed by open techniques.1 Adding a RAS program will play a key role in increasing the number of minimally invasive procedures performed in their hospital and the subsequent benefits that brings to patients.2,3,4 

Leading the way

Rafael Cohen, CEO, Pacifica Salud Hospital

“How can we do things differently?” That was one of the first questions that Rafael Cohen asked when he began his tenure as the CEO of Pacifica Salud Hospital over 7 years ago. He saw the value of investing in technology and innovation as a way to help differentiate the hospital and drive its growth. A robotic surgery program became an important part of this initiative.

The power of partnership

Cohen credits one key element in building their robotics program — teamwork. “The camaraderie shown betweenthe physicians, who may otherwise consider themselves as competitive colleagues since surgeons are not employees of the hospital, was instrumental to the program’s success,” shares Cohen. Approaching it as a comprehensive program rather than merely a device adoption was critical to bringing all the stakeholders along and making the program successful.

A win-win for everybody

“There is overwhelming positive consensus from everyone involved on how they feel about the program,” shared Cohen. Surgeons are enthusiastic and adopting the technology. Patients are highly satisfied. The hospital is making progress toward its goals and meeting economic expectations.

“At the end, we’re building a project that’s a win-win for everybody. A win for the hospital. A win for the physicians. And a win for the insurance companies and for the patients.”

Rafael Cohen, CEO of Pacifica Salud Hospital

On the horizon

Making robotic-assisted surgery accessible for everybody remains the focus as the Pacifica Salud program moves forward. Surgeons are already performing general, urologic and gynecologic procedures. The next milestone? Increasing the number and types of procedures to the point that it warrants an additional system.

“As more hospitals implement robotics programs, more procedures are performed, more systems are purchased, and costs will go down,” says Cohen. It’s all part of the vision of expanding access to RAS in Panama and around the world.

Choosing Hugo™ RAS System

When Pacifica Salud began their journey to add robotic technology, they evaluated current and future options. Though the Medtronic Hugo™ RAS System had not yet been released at that time, Pacifica Salud made the decision to delay their purchase until Hugo™ RAS System was available.

“We trusted the support the hospital has always received from Medtronic,” says Cohen, “and felt that level of support was essential. After all, hospital leadership wanted to build a successful program, not just buy a robot.”

Everyone had specific goals in mind for the use of an RAS System and their robotics program. “Many of the surgeons wanted the ability to do more complex procedures than the technology available at the time allowed. Others were interested in the comprehensive training programs offered by Medtronic,” said Cohen.

"We are witnessing the dawn of a new era in robotic surgery. That is made  possible by the Hugo™ RAS System, our partnership with Medtronic, and our talented team at Pacifica Salud.”

Rafael Cohen, CEO of Pacifica Salud Hospital

Encouraging results

From the start, Pacifica Salud tapped Medtronic’s Partners in Possibility Program for support in setting goals and getting their robotics program off the ground. With the goal of building a program, not just adding technology, Pacifica Salud brought together a team that set clear goals, created action plans to achieve those goals and then developed accountability standards for the entire team.

The first case at Pacifica Salud was completed in June 2021, followed by the first gynecological procedures in the world with Hugo™ RAS System in July. Cohen expects to finish the year with about 150 procedures performed, far ahead of their original expectations. Program development included:

  • Standardized rigorous training for 12 surgeons of various specialties
  • Proctor and mentor insight and feedback
  • Touch Surgery™ Enterprise to record and share procedures


  1. Panama Surgical Procedure Volumes (SPV) Database Accessed Aug 3, 2022.
  2. Hussain A, Malik A, Halim MU, Ali AM. The use of robotics in surgery: a review. Int J Clin Pract. 2014;68:1376-1382.
  3. Albani JM. The role of robotics in surgery: a review. Mo Med. 2007;104:166-172.
  4. Hyun SJ, Kim KJ, Jahng TA, Kim HJ. Minimally invasive robotic versus open fluoroscopic-guided spinal instrumented fusions: A randomized controlled trial. Spine (Phila Pa 1976). 2017;42(6):353–358.

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