Roundup of robotic surgery news – colorectal, endometrial, hysterectomy

As we’ve previously noted, with the explosive proliferation of robotic surgery systems in the US, it requires almost fulltime attention on a fulltime beat in order to stay on top of what is published about robotics.  I can’t devote that kind of fulltime attention.  But from time to time, I post research results that catch my eye.  So here’s another periodic robotics roundup:

Bloomberg News reports on a paper in the journal Obstetrics & Gynecology, “Comparison of Robotic and Laparoscopic Hysterectomy for Benign Gynecologic Disease.”  The story begins:

“Surgery to remove the uterus using a $1.5 million robot from Intuitive Surgical Inc. (ISRG) doesn’t reduce complications and may raise pneumonia risk compared with conventional less-invasive techniques, according to a second extensive study to find no added benefit from the devices.

Researchers examined data from about 16,000 women who had hysterectomies for benign conditions in 2009 and 2010. The robot operations cost hospitals $2,489 more per procedure with a similar complication rate as the standard practice of removing the uterus with minimally invasive equipment, according to the study released in the journal Obstetrics & Gynecology.

“Unfortunately, the greater costs associated with robotic-assisted hysterectomy were not reflected in improvement in outcomes,” said researchers at the University of Texas Southwestern Medical Center at Dallas.”

A colorectal surgical team from University Hospitals-Case Medical Center in Cleveland published a paper, “Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection.” They looked at a national inpatient database for colorectal surgery over a 30 month period and compared 17,265 laparoscopic procedures with 744 robot-assisted procedures. They report:

“The (robot-assisted) cases had significantly higher total cost ($5,272 increase, p < 0.001) and direct cost ($4,432 increase, p < 0.001), significantly longer operating time (39 min, p < 0.001), and were more likely to develop postoperative bleeding (odds ratio 1.6; p = 0.014) than traditional laparoscopic patients.”

So, they conclude, that the robot cases “had significantly higher costs and operative time than traditional (laparoscopic procedures) without a measurable benefit.”

Meantime, another paper, “Robotic colorectal surgery: summary of the current evidence,”  from the UK in another journal reported:

“Robotic colorectal surgery is both safe and feasible. However, it has no clear advantages over standard laparoscopic colorectal surgery in terms of early postoperative outcomes or complications profile. It has shorter learning curve but increased operative time and cost. …The technique has proved its safety profile in both colonic and rectal surgery. However, the cost involved may restrict its use to patients with challenging rectal cancer and in specialist centres.”

Laparoscopy versus robotics in the surgical management of endometrial cancer: comparison of intra-operative and post-operative complications,” was a paper from a French team. Conclusion:

“In this study, robotic surgery was not associated with a significant difference of intraoperative and postoperative complications, even if there was no intraoperative complication with robotic surgery.”

And the New York Times reported, “New Concerns on Robotic Surgeries,” on a study I reported on last week.


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