Health News Review

A piece in Barron’s, “Robots in Search of Added Employment,” offers a good update on the proliferation of daVinci robotic surgical systems.  From the piece:

  • No other big health-care company is putting up (earnings) numbers like (theirs).
  • The robot was used last year in about 450,000 surgeries of various kinds around the world.
  • The US accounts for nearly three-fourths of the installed base of 2,585 daVinci Systems.
  • Robotic prostate cancer surgeries fell 15% last year, to 62,000, in the U.S.—a decline that the company more than offset with 26% growth in robotic hysterectomies, to 176,000 in the U.S.
  • One surgeon reminded readers that “The technician is still more important than the technology.”

I wish, though, that the journalist had left his own story out of his reporting.  He wrote:

“It worked for the writer of this story. Nearly five years after my robotic surgery for cancer (see “Robot Dreams,” July 28, 2008), I’ve had no side effects or cancer recurrence.”

That sample of one does nothing but add a cloud over the rest of the story. Instead, he could have tried to include more about outcomes.  The closest he came was this:

“Just this month, the professional association of gynecologists who use such tools published a statement concluding that laparoscopic procedures were preferable to robotic for benign gynecological procedures—and much cheaper.

For most doctors, the robot is easier to use than the tools of laparoscopy. Still, good robotic surgery requires practice. A large number of adverse events in surgeries involving the robot have been reported to the FDA, available in a database assembled at the Citron Research Website (citronresearch.com) run by short seller Andrew Left.”

Nonetheless, the overall take home message of the piece is that the robotic proliferation may be slowing.  The story’s ending:

“Low-volume hospitals and surgeons may find their robots underutilized. And if high-volume centers manage to turn a profit on their efficiency, they won’t necessarily pass those savings on to society. In a cost study just out in the Journal of Urology—by Jim C. Hu, a urology professor at UCLA’s Geffen School of Medicine—high-volume hospitals proved more pricey for prostate surgery.

Intuitive shares deserve to trade at a premium to the stock-market multiple. But in light of the various head winds facing the company, it doesn’t merit a multiple that’s twice as high as the market’s.”

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Comments

Greg Pawelski posted on January 30, 2013 at 1:59 am

Barrons: “But growth could get harder to find.” Robotic surgery, largely pioneered for prostate cancer surgery, is rapidly being adapted for use in other areas, including for bladder cancer patients, according to urologic surgeons at New York-Presbyterian Hospital/Weill Cornell Medical Center. Their findings were published in an edition of the British Journal of Urology-International. Even the medical center’s Dr. Douglas Scherr admits, early indications that the surgery is at least as good as open surgery at removing cancer.

Jay Hancock posted on January 30, 2013 at 9:13 am

Gary: I saw the writer’s reference to his surgery less as a plug and more as a necessary disclosure. If the guy writing about the hardware was also a customer in a high-stakes situation, that’s something the reader needs to know.

    Gary Schwitzer posted on January 30, 2013 at 2:09 pm

    Jay,

    Thanks for your note.

    I agree to a point. The disclosure is almost mandatory since he interviewed his own surgeon.

    But it was not necessary for him to write that he has had no side effects or cancer recurrence. That’s an N of 1. The plural of anecdote is not data. And, as I went on to point out, there were no meaningful outcomes data provided in the story. That should be vital information for a financial magazine readership just as much as for a consumer health readership.