A new holiday tradition: See Santa & surgical toyland in the mall

We wrote about this one year ago, “Come to the mall to sit on Santa’s lap…or play with his robotic surgery system.” So, I guess, two years running makes a tradition.

That was about some New Jersey doctors playing with their robot at a New Jersey mall.  It must have been a big hit for the sponsoring medical center, because they’re doing it again this year in the same mall.   Love this quote:

Larry Batille, who works in the mall, said he had seen it before and was curious as to how it worked. Batille said it was quite easy to maneuver, but it wasn’t exactly what he thought it was.

“I thought it was an eye test,” he said. “It was interesting because you don’t really know what doctors use when they perform surgery.”

This year, the mall robot demos are popping up across the country.  First to catch our eye – because they mailed a news release – was an event sponsored by Humility of Mary Health Partners in Ohio.

It read:

Shoppers Invited to Operate Da Vinci Surgical Robot

WARREN, Ohio (Dec. 10, 2012) – St. Joseph Health Center, in cooperation with Intuitive Surgical, will offer shoppers the opportunity to “operate” using the da Vinci surgical robot during a special event Saturday, Dec. 15, at Eastwood Mall.

The da Vinci surgical system, which makes minimally invasive robot-assisted surgery possible, will be on display in the center court of Eastwood Mall from 10:30 a.m. to 5 p.m. Representatives from Intuitive Surgical and physicians from St. Joseph Health Center who use the robot to perform minimally invasive procedures in place of more traditional open surgeries will be available to answer questions and guide those interested through a hands-on experience using the robot.

Shoppers will be able to explore robot-assisted surgery from the surgeon’s perspective – sitting at the surgeon’s console, viewing the surgical field from a superior 3-D vantage point, and using the robot to control surgical instruments.

Robot-assisted surgery is the world’s most advanced surgical treatment option for a wide range of conditions and became available at St. Joseph Health Center earlier this year. Humility of Mary Health Partners is the only health care provider in nine contiguous counties (Mahoning, Trumbull, Columbiana, Ashtabula, Geauga and Portage counties in Ohio, and Mercer, Lawrence and Beaver counties in Pennsylvania) to offer the world’s most advanced, minimally invasive robot-assisted surgery.

And just like that – ho, ho, ho – Santa delivers news coverage.  See this in The Tribune Chronicle, “a daily morning newspaper serving Warren, Ohio and the Mahoning Valley area of the United States.” The story quoted one person saying, “The possibilities are unlimited.”  Unlimited apparently includes inviting teen-aged students to “try their hand to a more advanced video game.”  Excerpt:

”This is different from a video game. You get feedback immediately and you get the precise feel of what you’re doing,” said Sam Elliott, a junior at Warren Harding, who scored a 94 percent on the simulator on his first try.

Wow.  Let’s sign up him to do his first robotic prostatectomy then!



The event allowed one of the surgeons to post a “Thank You” on his group’s website, and a video of a story by a local TV station.  (You need to visit the group’s website in order to see the video – no embed code provided. Tip to the docs:  embed code would assist your marketing efforts and allow for broader distribution of this insightful journalism.)


Clearly, this is not just a holiday tradition.  A simple Web search shows:


I’m going to end my Web search because I must start my own list of “who’s naughty and nice.”

But as we wrote one year ago, there are important things that mall shoppers – health care consumers – were probably not told at this shopping site demos:

  1. The long learning curve for surgeons – one analysis showed that 3 experienced surgeons needed more than 1,600 cases to achieve acceptable outcomes with robotic-assisted laparoscopic prostatectomy.  A little bit different than showing shoppers how to manipulate rubber bands or pennies in the mall. (Please note: the 1,600 figure came from one analysis; others place the learning curve at 150-250 procedures.  At either end of the spectrum, caveat emptor.)
  2. With >2,000 of these $ million machines in place, how many surgeons have done 1,600 prostates? (or even 150-250?)
  3. A 2010 study showed robot-assisted hysterectomies were associated with longer surgical times and cost an average of $2,600 more.
  4. A recent story in Family Practice News reported that a recent explosion of interest in robotic surgery for routine hysterectomies and treatment of other non- oncologic gynecologic conditions is raising concern about the cost and comparative value of the robot over conventional laparoscopy.
  5.  In 2010, for the first time, more hysterectomies were performed with the da Vinci Surgical System than any other procedure, including prostatectomy.
  6. There have not been any large-scale randomized trials of robot-assisted surgery, and some doctors believe that “limited observational evidence fails to show that the long-term outcomes of robot-assisted surgery are superior to those of conventional procedures.”
  7. Bloomberg told the story of a urologist who confesses he was seduced by the robot. But that surgeon now rails against hospitals’ “tawdry marketing more familiar on late-night infomercials by using patient testimonials. “I cannot believe how quickly I recovered,” a vigorous-looking patient is quoted as saying. As a surgeon I have to ask: Where is the data?”

Ho, ho, ho.


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Skeptical Scalpel

December 19, 2012 at 11:26 am

I hear that the AAGL (formerly known as the American Association of Gynecologic Laparoscopists) will soon issue a position statement which will say that there is no proof that robotic hysterectomy results in better outcomes than conventional laparoscopic hysterectomy, and the extra costs associated with robotic surgery cannot be justified.