Starting the Conversation: Your Current OR Landscape

• How many minimally invasive surgery cases does your team perform in a typical month? Options: Under 50, 50–150, 151–300, Over 300
• Break down that monthly volume by specialty, for example general, bariatric, thoracic, gynecology. Options: General, Bariatric, Thoracic, Gynecology, Other (please specify)
• Who on your team typically advocates for adopting a new instrument or device during procurement discussions? Options: Lead surgeon, Service line director, OR director/manager, Value analysis committee (VAC), Supply chain/procurement
• Describe the reusable versus single-use mix you currently run for a standard laparoscopic case. Options: Mostly reusable, Balanced mix, Mostly single-use, Single-use for energy/stapling only, Unsure
• How satisfied are your surgeons with current instrument handling, tissue effect, and reliability? Options: Very satisfied, Generally satisfied with exceptions, Mixed feedback across surgeons, Dissatisfied

Where the Day-to-Day Friction Lives

• If a single instrument failure happened at a critical moment in the OR, how often would that change the surgeon's vendor preference? Options: Almost always, Often, Sometimes, Rarely, Never
• Walk me through a recent case where instrument handling or tissue effect changed the course of the operation, and what followed.
• How frequently do pauses, instrument swaps, or energy device issues occur across your MIS cases each month? Options: Multiple times per week, Weekly, A few times per month, Rarely
• Which role on the team notices these problems first and how is the issue usually escalated? Options: Surgeon, Surgical tech, Circulator/OR nurse, Clinical specialist/vendor rep, Other
• What single downstream cost or operational consequence creates the most pain when an instrument causes an OR delay? Options: Increased OR minutes, Delayed case starts, Patient morbidity/complication risk, Overtime pay, Rescheduling/throughput impact

Clinical Priorities That Really Move the Needle

• When handling, tissue effect, and per-procedure cost conflict, which priority usually determines the final choice in your setting? Options: Surgeon handling/tissue effect, Per-procedure cost, A balance of both depending on service, Unclear / varies by case
• Rank these priorities for your decision makers, where 1 is highest: handling, tissue effect consistency, energy device versatility, instrument reliability, per-case cost. Options: 1 - handling, 2 - tissue effect, 3 - energy versatility, 4 - reliability, 5 - per-case cost
• Tell me about measurable success signals you would accept from a pilot, for example reduced OR minutes, fewer conversions, or lower disposables per case. Options: Reduced OR time (minutes), Lower disposables per case, Improved complication/conversion rates, Surgeon preference/NPS, Other (please specify)
• How do you currently quantify an acceptable per-procedure cost change when a new device offers clinical benefit? Options: Percent cost increase tolerated, Absolute dollar per-case target, Break-even over X cases, No formal metric
• If a pilot delivered the clinical improvements you want but increased per-case cost by 10 percent, what would stop leadership from approving broader adoption?

Replaying the Procedure: Expectations for OR Performance

• Most devices look fine on paper but fail in the small intraoperative moments—what specific moments or steps in your cases make you most nervous about a new instrument? Options: Initial access/port placement, Critical dissection near vessels, Sealing/dividing tissue, Specimen extraction, Staple line formation, Other
• Walk me through a typical laparoscopic case and point to where instrument performance changes the surgeon's technique or timing.
• Select the objective measures you want collected during in-OR trials. Options: Seal time, Number of instrument exchanges, Smoke generation rating, Conversion to open, Instrument failure rate, OR minutes per case, Complication rate
• How much in-OR clinical specialist support do you require during the first 10 cases of a new device? Options: Full-time proctor for all cases, Partial support (first 3–5 cases), Remote/phone support only, No vendor support needed
• Would your team halt a trial if the lead surgeon reported compromised tissue handling in the first two cases? Options: Yes, stop immediately, Pause and investigate, Continue with adjustments, Depends on severity

Shaping the Trial: Scope, Volumes, and Acceptance

• Consider a trial that goes well across your service line, what specific outcomes would it need to demonstrate to replace the incumbent rather than just satisfy one surgeon?
• Choose the product mix you would want included in a trial. Options: Reusable-heavy set, Single-use-only for energy devices, Mixed reusable and single-use, Stapling included, Access devices only
• How many cases by surgeon and by service line do you consider meaningful to evaluate performance and cost? Options: 10–20 per surgeon, 21–50 per surgeon, 50+ per surgeon, Service line aggregate of 30–100 cases
• Select the acceptance metrics that would sway your value committee to approve purchase. Options: Per-case cost parity or better, OR time reduction (minutes), Reduced conversions/complications, Positive surgeon preference score, Inventory/resource simplification
• At what point would you consider ending the trial if tissue effect or clinical performance did not meet expectations? Options: After first 5 cases, After 10–20 cases, After service-line review at 30+ cases, We would not end early, need full trial
• Who holds the decisive approval for moving from trial to purchase, and what timeline would allow them to sign within a week? Options: Chief of Surgery, Service Line Director, VAC chair, Procurement Director, Multi-party signoff

Alternatives You're Actively Weighing

• Given existing contracts and surgeon loyalties, what would have to change materially for you to switch vendors or device strategy?
• Which of the following alternatives are you evaluating right now? Options: Renew incumbent contract, Move to a different external vendor, Internal reprocessing/standardization, Adopt more single-use devices, Develop an internal solution, Do nothing
• For each alternative you named, what would need to be true about it for you to stay with that option rather than change?
• Has anyone on your team proposed solving this internally instead of working with an outside seller? Options: Yes, active proposal, Yes, informal idea, No, Not sure
• Would a price concession without clinical proof be sufficient to halt plans to evaluate a new instrument? Options: Yes, No, Depends on concession size and duration

Operational Readiness and Practical Constraints

• Identify the single approval, system, or resource that would stop this project from starting on your timeline.
• List the internal stakeholders and owners who must sign off on a pilot and on final purchase.
• Do you have the reprocessing capacity and instrument tracking systems to absorb additional reusable instruments, or would new cases require external processing? Options: Sufficient on-site reprocessing, Need external processing vendor, Prefer single-use only, Unsure
• Are there committee reviews, contracting steps, or regulatory approvals that typically extend timelines we should plan around? Options: Value analysis committee, Infection control review, Legal/contracting, Budget cycle constraints, All of the above, Other
• Identify the person or role that owns OR outcome data and reporting and who can provide metrics for a pilot.
• Can the pilot proceed on your timeline if OR outcome data cannot be provided within 6 weeks? Options: Yes, No, Only with alternate data sources, Need to discuss

Acceptance Criteria and Next Steps That Speed Decisions

• Name the top three measurable results a pilot must deliver in the first 30 days to justify moving to purchase.
• Choose the acceptance thresholds you expect to be documented before broader rollout. Options: Per-case cost within ±5%, OR time improvement of ≥5–10 minutes, Surgeon preference score above target, No increase in complication rate, Supply chain and inventory plan agreed
• How quickly could your procurement and contracting teams execute a purchase order once acceptance criteria are met? Options: Within 1 week, 1–4 weeks, 1–3 months, Longer than 3 months
• After a successful pilot, list the final approval gates that could delay or block purchase. Options: VAC signoff, Budget/headcount constraints, Physician adoption variance, Supply chain terms, Other
• Is your team prepared to start a 30-case pilot if mutually agreed acceptance criteria and a documented price floor are in place? Options: Yes, ready now, Ready within 30 days, Ready within 3 months, Not ready
• What would be the single fastest action we could take together that would accelerate a decision to move from pilot to purchase?

• Procedure Experience Session

• Confirm the current state and its cost to your team
• You confirm the written current state and agree the cost impact described reflects your situation.
• Deliver the OR evaluation protocol and a metric scorecard showing how handling, tissue effect, time, and reliability will be measured and reported.
• You agree that the proposed in-OR evaluation captures the handling, tissue effect, and workflow metrics you care about for surgeon decision-making.
• Walk through a representative procedure and performance mapping
• Provide a modeled per-case cost comparison for current instrument mix versus the proposed trial configuration based on the provided case mix.
• Share three representative procedure types and recent case volumes to tailor the evaluation and cost model.
• You agree on adoption milestones and measurable success signals for surgeon signoff after training and trial cases.
• Run the planned in-OR evaluation protocol and metrics
• Review training and adoption support
• You agree on the remaining evidence and timeline required before a pilot or procurement decision.
• Identify the value analysis committee criteria and timeline so the pilot evidence can be aligned to approval requirements.
• Present the per-case cost model tied to instrument set choices
• Validate alignment, is this what you meant when you said you needed instrument handling, tissue effect, and cost transparency to decide?

• Procedure Experience Session
• Procedure Experience Deck
• Procedure Experience Brief

• meeting
• slides
• document

• Supply Reusable Laparoscopic Instrument Sets
• Supply Single-Use Energy Sealer Devices
• Provide Endoscopic Stapling Systems and Cartridges
• Deliver Trocars and Access Port Kits
• Install and Commission Insufflation Systems
• Install Smoke Evacuation Systems and Filters
• Deploy Visualization System and Camera Calibration
• Assemble Procedure-Specific Instrument Kits
• Configure Instrument Tray Layouts for OR Sets
• Deliver Hands-On Simulation Training Sessions
• Provide In-OR Clinical Specialist Support
• Supply Insufflation Consumables and CO2 Tubing
• Supply Disposable Device Sterile Packs

Supply Reusable Laparoscopic Instrument Sets

• Do you require reusable instrument sets for the full procedure or select steps? Options: Full procedure, Select steps only, No reusable sets
• How many laparoscopic cases per week should each reusable set support before reprocessing? Options: 1-5, 6-15, 16-30, 30+
• What instrument models or catalog numbers must be included (e.g., scissors, graspers, dissectors) for your standard lap chole set?
• Which procedure types will primarily use these reusable sets (choose all that apply)? Options: General surgery, Bariatric, Colorectal, Thoracic, Gynecology
• When do you schedule sterilization cycles for laparoscopic trays and what turnaround time is required between cases? Options: Same-day turnaround, Overnight, 24-48 hours, Other
• Who in your reprocessing team signs off on tray completeness and instrument integrity after sterilization?

Supply Single-Use Energy Sealer Devices

• Where will single-use energy devices be stored in the perioperative area and what footprint constraints exist?
• Are you tracking per-case consumable spend by device type today? Options: Yes, by device SKU, Yes, by procedure, No
• Please estimate the average number of cases per week that will use single-use energy sealers. Options: Less than 10, 10-30, 31-75, 76+
• Confirm the vessel size or tissue thickness ranges you expect the sealer to handle (e.g., up to 7mm vessels, gastric tissue thickness).
• Specify preferred activation modes or ergonomics required by your surgeons (e.g., paddle, trigger, bipolar/advanced sealing). Options: Paddle/footswitch, Hand trigger, Bipolar, Advanced sealing modes
• List any compliance or waste-disposal constraints affecting single-use device handling in your facility.

Provide Endoscopic Stapling Systems and Cartridges

• Identify the stapler and cartridge reload sizes you require for common procedures (e.g., 30mm, 45mm, reload color/type).
• Describe your OR team's cartridge inventory policy for stapling systems and preferred minimum on-hand counts.
• Provide the anastomotic or transection use cases where stapling performance is mission-critical.
• State the preferred staple height range or tissue compression parameters surgeons expect.
• Estimate the weekly number of stapler firings across the service line. Options: Less than 20, 20-50, 51-150, 150+
• Choose the sterile packaging and tray insertion requirements for stapler and reload delivery. Options: Single sterile pack per reload, Tray-based kits, Specialized case-by-case packing

Deliver Trocars and Access Port Kits

• Outline the trocar size mix you need in sets (e.g., 5mm, 10mm, 12mm, bladeless vs bladed).
• Specify the number of access ports required per procedure type and any set assignment rules.
• Identify the preferred seal mechanism and insufflation compatibility for trocars. Options: Valve seal, Universal seal, Insufflator-specific
• Describe any special requirements for bariatric or pediatric access (longer trocars, low-profile ports).
• Provide the expected lifetime or single-use preference for each trocar type. Options: Reusable with defined reuse cycles, Single-use only, Hybrid
• List acceptance criteria for port integrity and leak testing during initial evaluation.

Install and Commission Insufflation Systems

• Outline the insufflator performance thresholds you require such as pressure stability and gas flow range.
• Identify operating room integration points needed for insufflator commissioning (gas outlets, power, mounting).
• Describe your CO2 supply arrangements and back-up plans for uninterrupted insufflation.
• Confirm supply frequency and cylinder versus centralized pipeline preference for CO2 consumables. Options: Cylinder, Central pipeline, Hybrid
• Indicate CO2 tubing length and connector types used in your ORs.
• Provide the acceptance test checklist items and pressure stability tolerances for system sign-off.

Install Smoke Evacuation Systems and Filters

• Specify filter change intervals and capture efficiency requirements for smoke evacuation filters.
• Provide the expected connectivity to OR booms or ceiling mounts for evacuation units.
• List the typical procedures where smoke evacuation must be active from incision to closure. Options: Laparoscopic cholecystectomy, Bariatric sleeve, Thoracoscopic lobectomy, Gynecologic hysterectomy
• State the noise and footprint limitations in your ORs for evacuation units.
• Identify electrical or USB ports needed for integration with visualization systems.
• Who on your team is responsible for filter replacement scheduling and what log format do you use for maintenance records?

Deploy Visualization System and Camera Calibration

• Describe the display sizes and mounting configurations used in your ORs for visualization systems.
• Estimate peak weekly hours the cameras will be in use and required uptime. Options: Less than 20 hours, 20-60 hours, 60-120 hours, 120+ hours
• Provide any DICOM or video streaming requirements for integration with your recording systems.
• Do you require remote camera calibration support during initial rollouts? Options: Yes, on-site, Yes, remote, No
• How many camera heads and light sources should be commissioned per OR? Options: 1 camera/1 light, 1 camera/2 lights, 2 cameras/2 lights, Other
• What instrument connectors and cable lengths must be supported for your scope inventory?

Assemble Procedure-Specific Instrument Kits

• Which procedure templates do you want pre-configured into kits (provide procedure names and typical instrument lists)?
• When do you require kit swaps between sequential cases and what is acceptable swap time? Options: Less than 5 minutes, 5-15 minutes, 15-30 minutes, 30+ minutes
• Who will own kit configuration changes in your OR: clinical engineer, charge nurse, or surgeon? Options: Clinical engineer, Charge nurse, Surgeon, Supply chain
• Where should procedure-specific kits be staged relative to the sterile field? Options: In-OR on Mayo stand, Peripheral cart in OR, Sterile core outside OR
• Are there any single-use items that must be included in every kit for regulatory reasons? Options: Yes, No
• Please estimate the percent of cases that will use a procedure-specific kit versus standard trays. Options: 0-25%, 26-50%, 51-75%, 76-100%

Configure Instrument Tray Layouts for OR Sets

• Confirm the maximum number of instrument positions per tray and cart dimensions to accommodate your sterile storage.
• Specify instrument layout preferences such as instrument order, labeling, and shadow trays.
• List any compatibility requirements with your sterilization racks and instrument pass-through systems.
• Identify the reuse cycle and maintenance schedule the tray configuration must support.
• Describe how you measure tray completeness and who audits tray missing instruments.
• Provide the preferred material finish or corrosion resistance requirements for tray inserts. Options: Silicone/soft inserts, Metal inserts, Custom foam

Deliver Hands-On Simulation Training Sessions

• Indicate the surgeon skill levels to include in simulation sessions (novice, intermediate, advanced). Options: Novice, Intermediate, Advanced, All levels
• Estimate the number of attendees per simulation session and desired instructor ratio.
• Select training formats you prefer: cadaver lab, high-fidelity simulator, or on-site OR proctoring. Options: Cadaver lab, High-fidelity simulator, On-site proctoring, Virtual
• Outline the training curriculum objectives related to instrument handling, tissue effect, and device troubleshooting.
• State the tissue types or procedure steps where simulation must demonstrate acceptable tissue effect (e.g., sealing gastric tissue without charring).
• Estimate the timeframe for scheduling initial training from contract execution. Options: Within 2 weeks, 2-6 weeks, 6-12 weeks, 12+ weeks

• Purchase Agreement
• Order Confirmation
• Pilot Agreement
• Master Services Agreement (MSA)
• Statement of Work (SOW) — Clinical Support & Training
• Supply & Logistics Agreement
• Commercial Terms Summary
• Governance & Clinical Adoption Agreement
• HIPAA Business Associate Addendum (BAA) — conditional
• Performance & Acceptance Certificate

• Go-live Health Check (weeks 1-4)
• First Measurement Review (weeks 4-10)
• Acceptance Gate Review (around day 90)
• Quarterly Success Review (ongoing)

• Move prioritized enhancement requests into the backlog with estimated delivery windows and documented acceptance criteria.
• Restate acceptance criteria and numeric targets
• Each acceptance criterion from the Solution Scope is evaluated and recorded as pass or fail.
• A documented acceptance decision by the buying owner is captured, or conditional acceptance terms and remediation timelines are recorded.
• Any incumbent device wind-down tasks are scheduled if the deal replaces an existing system.
• Publish the acceptance decision record and the pass/fail per criterion to the shared workspace.
• Execute and track remediation items on a shared register with firm resolution dates.
• If applicable, confirm contractual steps to retire or retain the incumbent device and archive legacy data.
• Review clinical performance and safety metrics
• Clinical performance and safety metrics show continued alignment with operational targets or have remediation plans with dates.
• Disposable cost per procedure and utilization trends are understood and any cost drivers are assigned remediation actions.
• Open issues and enhancement requests are prioritized with resolution timelines entered into the shared backlog.
• Update the shared outcome dashboard with the latest clinical, safety, and cost metrics before the next review.
• Schedule targeted training refreshes or inventory adjustments tied to metric improvements and record expected impact.
• Re-confirm success criteria and owners
• Deployment checklist confirmed complete or a remediation plan recorded for any gaps.
• Training uptake and in-OR coverage validated against the rollout plan.
• Immediate operational blockers documented with remediation actions and deadlines.
• Distribute the go-live validation summary and open-issue register for asynchronous updates.
• Implement short-term containment fixes for any issues raised and record resolution dates.
• Schedule the First Measurement Review within 4 to 10 weeks post go-live.
• Present first outcome data versus targets
• Primary metrics (surgeon satisfaction score, disposable cost per procedure, intraoperative device failure rate) reviewed and a root-cause diagnosis for each gap established.
• Corrective action plan with dates and measurable impact on the named metrics agreed.
• Measurement ownership and reporting cadence confirmed through the acceptance window.
• Publish the first-measurement dashboard and root-cause notes to the shared workspace.
• Execute the agreed corrective actions, including additional clinician coaching sessions or instrument set adjustments, and report status at the acceptance gate.
• Finalize the data extraction method for disposable cost per procedure to ensure consistent reporting.
• Deployment and configuration validation
• Review cost-per-procedure and consumption trends
• Diagnose root causes for any gaps
• Present outcome data for each acceptance criterion
• Agree specific corrective actions and timelines
• Document pass/fail per criterion and formal acceptance decision
• Open issues, defect burn-down, and enhancement requests
• Early adoption signals and training uptake
• Confirm data sources and reporting cadence
• Blockers and open issues triage
• Agree remediation items and resolution timeline
• Agree ongoing actions and next review cadence
• Incumbent wind-down checkpoint, if applicable
• Agree immediate remediation actions and follow-ups