The Robotics Controversy

“Aggressive direct-to-consumer marketing of the latest medical technologies may mislead the public into believing that they are the best choice. Our patients deserve and need factual information about all of their treatment options, including costs, so that they can make truly informed health care decisions.” -Dr. James Breeden, President, American Congress of Obstetrics and Gynecology.

 

The Robotics Controversy: Tools Cannot Replace Skill
The two most important aspects of choosing a GYN surgeon for any patient should be expertise and skill. A surgical instrument like the robot cannot improve lack of surgical training. Robotic procedures performed by a lesser skilled surgeon can create many problems, including increased blood loss, complications resulting from injury and longer recovery. Learn why ACOG president, James T. Breeden, does not support Robotics.
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WHAT IS ROBOTIC SURGERY?robot_full-274x300

Robotic surgery is performed with the surgeon sitting at a control station, controlling robotic “arms” that have been inserted into the patient’s abdomen at the beginning of the surgery. Under direction from the surgeon, the robotic arms can cut blood vessels, burn tissue, and move organs.

Robot-assisted surgery generally requires four to five skin incisions, through which robotic arms can be placed into the patient’s abdomen. These incisions are eight to 12 mm each and are placed above and below the belly button in an arc.

INCISION COMPARISON CHART

The robot–called the DaVinci Surgical System–is manufactured by Intuitive Surgical. It costs approximately US $1.5-2 million dollars, with a maintenance cost of $150,000-$180,000 per year; it also requires costly disposable instruments.

Many studies have shown that the robotic approach does not have any clinical advantages over regular laparoscopy. It takes longer to perform the surgery and at a much higher cost.

USA TODAY

Read more about it here: “Robot-assisted Hysterectomies booming, but better?”, USA TODAY, February 19, 2013

“There is no good data proving that robotic hysterectomy is even as good as–let alone better than–existing, and far less costly, minimally invasive alternatives.” -Dr. James Breeden, President, American Congress of Obstetrics and Gynecology

WHAT IS CONVENTIONAL LAPAROSCOPIC SURGERY?

“Conventional” laparoscopy does not use a robot to operate the instruments. With this procedure, the surgeon actually holds the instruments and camera. The surgery is typically performed using 5 mm skin incisions in the lower abdomen. Conventional laparoscopy has been done for years, and is the traditional approach to laparoscopic surgery. Newer modifications such as DualPortGYN laparoscopic surgery are now also available.

SO WHAT IS ALL THE CONTROVERSY SURROUNDING ROBOTICS?

In Gynecology, it has become clear through scientific articles in major journals that robotic procedures offer no benefit compared to conventional laparoscopy, and are much more costly. Despite this fact, the number of robotic surgeries being performed has skyrocketed in the past five years, mainly due to:

  • Aggressive direct-to-consumer marketing by Intuitive Surgical, the company that manufactures the robot; and
  • Aggressive marketing to doctors and hospitals to convince them to adopt the technology, in order to attract more business.

    “Aggressive direct-to-consumer marketing of the latest medical technologies may mislead the public into believing that they are the best choice. Our patients deserve and need factual information about all of their treatment options, including costs, so that they can make truly informed health care decisions.” -Dr. James Breeden, President, American Congress of Obstetrics and Gynecology.

  • Major Journals or Societies indicate that Robotics offers no benefit compared to Conventional Laparoscopy:

    • JAMA_logo
    • JMIG-logo
    • NEJM-logo
    • acog-logo

HAVE THERE BEEN ANY LEGAL ACTIONS AGAINST INTUITIVE SURGICAL, THE MANUFACTURER OF THE DAVINCI ROBOT, OR FDA WARNINGS?

Yes. Class action lawsuits have been issued and are being developed by multiple law firms throughout the United States, given the complications reported from robotic surgeries. The U.S. Food and Drug Administration issued a recent warning against Intuitive Surgical.

The Robotics Controversy In The News