Robotic surgery systems are expensive. As in, more than a million dollars expensive (somewhere between $1.3 and $1.7 million, as a matter of fact). Part of that cost is passed on to the patient, of course. A typical robot-assisted surgery is $1,500 to $2,000 more than traditional surgery [source: Kolata]. As the ongoing debate about the state of health care in the United States shows, it's hardly news that people with more money can afford better health care.
The question is whether robotic surgery is better.
Of the hospitals that advertise robotic surgery on their Web sites, 73 percent of them use stock text from the manufacturer to tout the benefits of the system: fewer complications, faster recovery time, less pain, less blood loss and improved cancer control [source: Johns Hopkins Medicine].
It doesn't take a brain surgeon to figure out that a hospital presenting information from a manufacturer with serious financial stakes in the outcome of patient choice is a conflict of interest -- especially considering that there's no body of rigorous scientific studies to back up the claimed benefits. (There are a few studies that show improved outcomes in certain types of surgeries, but not enough information to be conclusive or justify such strong claims without caveat.)
Robotic surgery has its risks, too. Remember that it's a new technology, and that it will take a surgeon a few hundred surgeries to become expert at it. The surgery requires anesthesia and is also very long, making anesthesia more complicated. You won't see much of that on hospital Web sites, however. For example, despite the growing number of prostate cancer surgeries (4 in 5 are robotic), fewer than half the men who had reported a satisfying sex life beforehand could get an erection after [source: NPR].
Hospitals are a business just like any other. They have to attract consumers in order to offset the costs of running the business, from staff salaries to expensive equipment like robotic surgery systems.
The difference is that most other businesses don't have access to a population that is ill and vulnerable, and their claims aren't a matter of life and death. If a cancer patient is told that a robotic surgery has a better chance of eradicating cancer but costs thousands of dollars or more, he or she is likely to try mightily to come up with that money. But as we've seen, there's no evidence that it's any more effective than the cheaper, traditional surgery.
The rise in robotic surgery, then, seems to be more the effect of marketing than proven clinical benefit.
Need some more information before booking your next surgery? Peruse the links and resources below.
- Chodak, Gerald. "Is Robotic Surgery Overhyped?" Medscape Today. June 8, 2011. (Oct. 4, 2011) http://www.medscape.com/viewarticle/743935?src=smo_tw_urol
- da Vinci Surgery website. (Oct. 2, 2011) http://www.davincisurgery.com/
- Intuitive Surgical Inc. "Company Profile." July 2011. (Oct. 4, 2011) http://www.intuitivesurgical.com/company/profile.html
- Johns Hopkins Medicine. "Hospitals Misleading Patients About Benefits of Robotic Surgery, Study Suggests." May 18, 2011. (Oct. 4, 2011) http://www.hopkinsmedicine.org/news/media/releases/hospitals_misleading_patients_about_benefits_of_robotic_surgery_study_suggests
- Kolata, Gina. "Results Unproven, Robotic Surgery Wins Converts." The New York Times. Feb. 13, 2010. (Oct. 9, 2011) http://www.nytimes.com/2010/02/14/health/14robot.html
- Lanfranco, Anthony R., et al. "Robotic Surgery: A Current Perspective." Annals of Surgery. Medscape Today. Jan. 13, 2004. (Oct. 9, 2011) http://www.medscape.com/viewarticle/466691
- Morris, Bishoy. "Robotic Surgery: Applications, Limitations, and Impact on Surgical Education." Medscape General Medicine. Sept. 27, 2005. (Oct. 9, 2011) http://www.medscape.com/viewarticle/511854
- Northwestern Memorial Hospital. "Study Finds Robotic Surgery to Treat Endometrial Cancer Associated with Improved Surgical Outcomes and a Shortened Learning Curve." Aug. 7, 2009. (Oct. 2, 2011) http://www.nmh.org/nm/robotic-surgery-endometrial-cancer
- NPR. "Many Patients Suffer Post-Prostate Cancer Surgery." Oct. 3, 2011. (Oct. 3, 2011) http://www.npr.org/2011/10/03/141014060/many-patients-suffer-post-prostate-cancer-surgery
- Phillips, Carmen. "Tracking the Rise of Robotic Surgery for Prostate Cancer." NCI Cancer Bulletin. National Cancer Institute. Aug. 9, 2011. (Oct. 9, 2011) http://www.cancer.gov/ncicancerbulletin/080911/page4
- Reinberg, Steve. "Robotic Surgery Oversold on Hospital Websites, Study Contends." HealthDay. May 20, 2011. (Oct. 2, 2011) http://www.healthfinder.gov/news/newsstory.aspx?docID=653137