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Jim Lewis
Jim Lewis
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Recent Study Says Robotic Surgery Costly Alternative With Questionable Medical Benefit

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A recent study published in the Journal of the American Medical Association threw cold water on the recent trend of huge increases in the numbers of robotic surgeries performed each year. Though the number of procedures performed by robots, such as Intuitive Surgical’s da Vinci system, is on a rapid rise, the medical benefits remain in doubt.

As hospitals engage in a battle for market share and financial supremacy, technology continues to be trotted out as evidence of medical superiority. One of the areas that has most boomed due to robotic surgeries are those involving hysterectomies. Hysterectomies are among the most common surgeries performed in the U.S., with nearly 600,000 taking place each year. Results show that more and more hysterectomies are being performed by robots, yet the supposed benefits are unclear.

Despite the buzz about the technology, medical experts have long cautioned about the questionable benefits of robotic surgery. As with many things, new trends receive lots of attention, but that attention does not always translate into genuine benefit for patients. The recent JAMA study supports this idea, with data revealing robotic surgeries are more expensive than the ones performed laparoscopically and have no benefit in terms of improved medical complication rates.

Currently there are four main surgical techniques for performing a hysterectomy: vaginal surgery, abdominal surgery, laparoscopic surgery and robotic surgery. Previous studies have shown that vaginal hysterectomies offer the best overall outcomes for patients, but for those who are not candidates for such surgery, laparoscopic hysterectomies have some important advantages over adnominal surgeries. Laparoscopic hysterectomies have been found to result in a shorter hospital stays, decreased blood loss, quicker recovery time and less wound infections.

Researchers at Columbia University who are behind the recent JAMA study started by creating a database of millions of hospital records and used the database to identify thousands of women who had undergone a hysterectomy for a benign disorder between 2007 and 2010. The study ultimately collected data from more than a quarter of a million women who underwent the procedure.

During the course of the study the number of robotic procedures increased significantly, by more than nine percent. Among those hospitals that performed robotic procedures, the researchers found that in three years robots went from performing zero surgeries to handling more than 22 percent of all hysterectomy procedures.

Despite the boom in the number of robotic surgeries, researchers say there were no significant differences in the rates of complications during and after surgery between patients who underwent laparoscopic surgery and those who used robots. Despite a lack of clear medical benefits, robotic surgeries were several thousand dollars more expensive than even those performed laparoscopically.

The case represents a perfect example of how consumers often miss out on important information that can be relevant to their care. Robotic surgery has increased exponentially in recent years thanks largely to slick marketing campaigns put on by the manufacturers of robotic surgical systems as well as the hospitals and surgeons who use them. While direct-to-consumer marketing can be beneficial when patients receive information vital to their health, its value is questionable in cases like this where the advertised product has few if any advantages. Just because something is new or cutting edge does not make it good. Instead, the robotic surgical systems should be put through their paces and need to prove that they represent a real improvement over existing methods.

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