What we found out

Project objectives Tweet

The project concerns the strengthening of health services at San Carlo Hospital through the modernization of equipment and the introduction of new technologies. The intervention aims at optimizing the facility's operational capacity, focusing on technological upgrades to more effectively manage medium- and high-complexity surgical performance. The goal is to ensure safer and more advanced interventions. The importance of the project lies in improving the quality of care offered to the community. Through the integration and qualification of social and health services, the intervention aims to build a more robust care system.
The main objectives of the project are: to renew the hospital's technological fleet through the introduction of advanced tools useful for managing complex surgical procedures; to improve the quality standards of healthcare services; and to enhance services dedicated to minors.

Foreseen activities

The project, funded under Action 3 – Axis 7 of the Basilicata 2014-2020 POC, focuses on the technological renewal of robotic surgery at the San Carlo Hospital in Potenza. The specific intervention consists of replacing the third-generation platform (dating back to 2013) with a fourth-generation robotic system, necessary to overcome technical obsolescence and ensure the operational continuity of San Carlo as a regional hub (Level II A&E). The activities include the completion of the tender through the SUARB (Single Contracting Authority), the installation of new vision and surgical precision technologies, and the extension of clinical applications not only to urology and general surgery, but also to new areas such as gynecology, cardiothoracic surgery, and upper airway surgery.
In terms of timing and administrative progress, the project followed the procedures of Legislative Decree 50/2016, with the publication of the tender in the GUUE and GURI and the award according to the criterion of the Most Economically Advantageous Offer (OEPV). The investment, estimated at €2,000,000, has already passed the crucial stages of disbursement and verification: following the transfer of resources, a first-level check was carried out with positive results. This formal step confirms the regularity of the procedures and the compliance of the activities carried out with the requirements, establishing the full operation of the new robotic equipment for the benefit of patients and the reduction of passive healthcare mobility.

Project origin

The project stems from the Regional Operational Program (ROP), financed by the European Regional Development Fund (ERDF) for the 2014-2020 European programming period, which has allocated €2,440,000 for the implementation of this project. The project was developed through collaboration between the European Union, the Basilicata Region, and the San Carlo Hospital. Although the project addresses widespread needs (childhood and non-self-sufficiency), the definition phase was mainly technical and administrative in nature. Specific groups, such as patient associations or neighborhood committees, may not have been directly involved in participatory co-design, remaining partially excluded from the initial decision-making phase.

Beneficiaries

The economic and social impact of adopting the Da Vinci Xi system affects a diverse group of stakeholders, generating clear benefits for some while creating challenges or barriers for others. The main beneficiaries of the project are certainly surgeons, who gain several advantages such as reduced physical stress during operations, and patients, who are at the center of the benefits.
This technology guarantees a less traumatic surgical experience, with smaller scars, reduced blood loss, and a much faster recovery of daily functions. As a result, patients experience a better post-operative quality of life. The hospital also benefits from the project because the presence of such advanced technology transforms it into a center of excellence, capable of attracting top professionals and already trained surgeons who prefer to work in technologically advanced facilities. This creates a virtuous cycle that increases the scientific level of the entire institution.
However, there are also some stakeholders who may experience negative consequences. These may include patients who personally believe that being operated on by robots or machines is inappropriate or unsafe. In fact, there is a group of users who perceive robotic mediation as a loss of the direct relationship and the safety of the surgeon’s “human touch.” For these people, technological innovation can cause anxiety or distrust, as they fear that a possible mechanical failure or the absence of the doctor at the operating table could compromise the success of the surgery.
The introduction of such an impactful technology can also create a sense of professional obsolescence among some healthcare workers (doctors or operating room nurses) who, due to age or lack of access to training courses, remain excluded from the new protocols. This situation can generate work stress and a sense of frustration within hospital departments.
Peripheral hospitals that cannot afford the Da Vinci Xi system may also face indirect consequences, such as a loss of prestige and funding, since the most talented surgeons and many patients tend to move to centers equipped with robotic technology, further weakening local healthcare facilities.
Finally, another excluded group could be medical students and residents from universities that do not have robotic surgery centers. The lack of this opportunity or of simulation laboratories in most Italian universities creates a barrier to entry for young doctors. This educational exclusion turns robotic surgery into a path “for a few,” accessible mainly to those who have the financial resources to attend private master’s programs or training centers abroad.

Context

The robotic surgical system operating at San Carlo represents a cornerstone of technological innovation in Southern Italy. The project offers residents numerous benefits and highly specialized services that previously required travel to northern Italy. Investment in this type of project has made it possible to address the need for minimally invasive procedures that reduce hospital stays and post-operative discomfort.
The effectiveness of this project is confirmed by data regarding the number of operations performed between 2021 and 2025 at the hospital itself. During this period, 652 procedures were performed, all with the Da Vinci robot, and steady growth was observed, from 102 in 2021 to 216 in 2025. The department with the most operations was urology, with 528 total procedures from 2021 to 2025; Of particular note, however, is the radical change in general and emergency surgery. In 2021, the latter numbered only two operations, while in 2025, the number of operations rose to 106.
However, Potenza is not the only hospital with such an advanced surgical system; similar technology has been implemented in Matera, where the hospital uses the HUGO system. Globally, the Da Vinci system is the most widely installed of the two, with over 10,000 units. However, for both, the medical team using these types of machines requires extensive training to know how to use and make the most of them. Although malfunctions are extremely rare, patient safety is always the focus of monitoring.
The robotic system used in Potenza represents not only a technological tool but also a project to modernize healthcare in Basilicata, as it allows for much shorter waiting times and internationally recognized standards of care within the region.

Progress

The technological investment made in Potenza to purchase the da Vinci Xi robotic surgical system represents a high-level healthcare financial engineering operation that goes far beyond the simple acquisition of a cutting-edge machine. Analyzing OpenCoesione data, which reports a total cost of €2,440,000.00 against a payment already made of €2,369,600.00, clearly shows that the primary objective is to transform an initial fixed cost into long-term structural savings for the entire Basilicata Region.

Results

Based on the evidence collected during monitoring activities, such as interviews with our teammates, and the analysis of technical documentation from the Director of the provveditorate, Mr Falasca, the main results achieved by monitoring are outlined below. Among the project's beneficiaries, the patient is the protagonist. The project's efficiency affects the patient from various perspectives, including faster post-operation recovery: this involves early size and immediate recovery of physiological functions thanks to the minimally invasive arms used. This system allows for many more surgical operations, 652 in five years, including emergency surgery and urology. The introduction of this new machine also depended on the arrival of specialized staff within the hospital facility, one more unit than before. The reported data indicate the arrival of Dr. di Marino at Ospedale San Carlo as a new member of the hospital team, employed in surgery, starting November 16, 2024. (https://share.google/0U0RRXOpbywGec7O2) From the analysis of what has been collected, our team argues that the value of thisproject lies above all in its ability to transform innovation into real well-being. Seeing how minimally invasive technology actually translates into record patient recovery confirms that the system's utility improves the patient's post-operative experience. The introduction of new specialized staff in the hospital system also increases the value of the hospital and consequently it increases patients' trust in the public service.

Risks

One of the main risks concerns possible technical problems. Surgical robots are very complex tools that work through software, electronic components, and advanced digital systems. If failures, system errors, or malfunctions occur, surgical operations could slow down or face difficulties, affecting the precision of the procedure.

Another factor to consider is the very high cost of these technologies. The purchase, installation, and maintenance of robotic machines require significant investments from hospitals. This could limit the spread of such tools and make it more difficult to carry out or continue the project in the long term.

In addition, specific training is necessary for surgeons and healthcare staff to use these systems correctly. They must learn how to operate the robot accurately and safely. If the training is not sufficient or regularly updated, the risks during operations could increase.

Finally, it is also important to consider possible issues related to responsibility in case of errors and the security of patient data. Since these systems are connected to computer networks, they must ensure a high level of protection for sensitive information.

Investigation method

How was the information collected?

• Web research
• Visit to the project's location, documented by pictures or videos
• Interview with the Managing Authority of the Programme which financed the project
• Interview with people responsible for the project's planning
• Interview with people responsible for the project's implementation

To learn more about the progress of the project at the San Carlo Regional Hospital, we interviewed the following key figures:
Dr. Giuseppe Spera: General Manager of the San Carlo Hospital;
Biomedical engineering Mastrodonato: Biomedical Engineer responsible for technical and technological aspects;
Dr. Falasca: Director of the Complex Operational Unit (U.O.C.) and senior administrator within the facility;
Dr. Aloè: The Responsible of the RUP at the San Carlo Hospital;
Dr. Di Marino: Surgeon specialized in general and robotic surgery;
Dr. Falabella: Surgeon specializing in robotic urological surgery.
All of the above individuals belong to the San Carlo Hospital organization and have contributed to the technological implementation and enhancement of the surgical services provided for in the project.

Main questions

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Main answers

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