A new Da Vinci code

Our Review Summary

The use of a robotic system for the surgical removal of fibroids (a procedure known as myomectomy) could, in theory, allow easier, less invasive access to difficult-to-remove fibroids that would otherwise only be reachable through a large incision. However, the relatively limited experience performing myomectomies with the robotic system means that little can be said about how the system compares in terms of safety and efficacy with standard surgical approaches. And serious economic concerns raise questions about whether the benefits of the system are worth the considerable additional expense.

This story does a good job of outlining the novelty and availability of the robotic system.

However, the story fails to adequately address the cost issue. Although the story describes how much the equipment costs and mentions that reimbursement is the same regardless of whether the equipment was used, this is not adequate information on costs. Because of insurance issues and the fact that the system is so expensive relative to traditional surgical approaches, this is important information that should have been covered in more detail.

Nor does the story adequately quantify the benefits of treatment or describe the potential harms. In fact, with such statements as "it’s hard to see the negative impact of new technology" and "the robot is very precise," the story appears to suggest that there aren’t any downsides.

The story also to adequately describe the strength of the available evidence to support the use of the robotic system. Specifically, it is not clear how strong the evidence is that the new system is as safe or effective as it is claimed to be. To date, there have been no controlled trials comparing the system to other myomectomy methods.

Finally, the story explained that the robotic device came on the market just 8 years ago, that Minnesota hospitals started using it just three years ago., and that there are already nine da Vincis in the state. But the story didn’t address the obvious followup questions: how many does a state or a community need? Who’s asking these questions?