For quite a while now, we’ve been hearing how robots are revolutionizing surgery all across the world. Minimally invasive. Smaller incisions. Quicker recovery.
But a new study has found that maybe, just maybe, patients might not be better off with the expensive machines, according to a story by Frederik Joelving at Reuters (News
- Alert) Health.
In the latest study, Joelving writes, researchers found the same complication rates among women treated for endometrial cancer whether a robot was used or not, despite the fact that robotic surgery “costs about $1,300 more than the low-tech approach, called laparoscopy, in addition to the upfront cost to the hospital of the machine itself.”
"Robotic surgery is clearly associated with higher costs, without any clear advantages," Dr. Jason Wright, a gynecologic surgeon at Columbia University in New York, told Reuters Health, Joelving reports.
Wright says in a report in the Journal of Clinical Oncology that millions of dollars could be saved by switching back to traditional laparoscopy, although official regulation might be required, Joelving writes.
"Surgeons need to keep in mind all of the modalities that are available to them," Wright told Reuters Health. "The newer, more technologically advanced ones aren't always better."
Where’s all the hype coming from? Possibly, manufacturers and hospitals wishing to justify purchasing the costly machines, which cost between $1 million and $2.25 million each, Joelving writes. In fact, “the drive to develop and obtain robotic devices has been largely driven by the market,” the Annals of Surgery concurs.
Even scarier -- are they truly safe? Earlier this year, a study on men who had their prostate removed due to cancer “complained just as frequently about sexual problems and urinary leakage after robotic surgery as when they'd had the traditional surgery,” according to Joelving’s story. And hospitals that do invest in robots see huge increases in the number of surgeries they do, fueling concerns that the technology could lead to unnecessary treatments, he adds.
Nearly 60 percent of the 40,000 women diagnosed with endometrial cancer in one study had their surgeries performed robotically, Joelving reports, explaining that, in robotic surgery, “the surgeon sits at a console, operating robotic ‘arms’ that use fine tools to extract the uterus through small cuts in the abdomen.”
But those who had the traditional laparoscopic surgery, without assistance from robots, suffered only slightly more complications than those with robotic-assisted surgery, 9.8 percent vs. 8.1 percent, Joelving reports.
Wright told Reuters Health the gap was "pretty small," and even pointed out that it “disappeared after accounting for differences in race, insurance status and hospital location.”
"The bottom line is that there is really no difference in the complication rate between robotic and laparoscopic surgery, but robotic is much more expensive," Wright told Reuters Health.
But other doctors disagree. In fact, Dr. David Samadi, vice chairman, department of urology, and chief of robotics and minimally invasive surgery at The Mount Sinai Medical Center, says that robotic surgery saves lives.
Still, Wright and his colleagues feel much remains to be determined about the value of robotic-assisted surgery. "A lot of that hype is coming out of the (manufacturing) company," he said. "For the majority of patients, it could be done either way."
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Deborah DiSesa Hirsch is an award-winning health and technology writer who has worked for newspapers, magazines and IBM (News
- Alert) in her 20-year career. To read more of her articles, please visit her columnist page.Edited by
Rich Steeves