Since 2003, when the Da Vinci robot was approved for use, doctors and patients alike have embraced robotic surgery. However, there have been growing concerns about the cost-effectiveness and the reduced risk of complications from robotic surgery.
Here's an assessment of the pros and cons for robotic surgery.
Advantages for surgeons
If you perform frequent surgical operations, instead of spending hours on your feet, bending awkwardly over your patient, robotic surgery allows you to be seated at a console away from the operating table. The ergonomics of operating this way is kinder on your body and can help focus and concentration.
The system is calibrated and movements are scaled in millimetres for your own hand movements, while any surgical tremor is filtered.
The technology uses a 3D camera to give a view of areas inside your patient, and has flexible arms that can reach hard to access areas with minimal cutting to other tissues.
This provides better vision, dexterity and control than would be possible for human hands, reducing operative risks for the best possible results.
Disadvantages for surgeons
The technology is simply an interface for advanced vision and instrumentation; it doesn't replace surgical skills for the success of an operation.
The most controversial disadvantage for robotic surgery is the cost effectiveness. A 2010 study in the New England Journal of Medicine found that using a robot added about US$3,200 to the average cost of a procedure. With the added cost, is it money well spent?
Recent evidence published in the NEJM has found patients with invasive bladder cancer still required open surgery. At the second portion of the operation when the patients' bladders are reconstructed, robotic surgery is unfortunately unable to perform this part of the operation. So even though the procedure costs more, open surgery was still performed on these patients.
Advantages for patients
Robotic surgery can be used for complex procedures to replace standard and keyhole surgery, reducing the risk of infection and giving a faster recovery. Patients can be discharged within a few days of surgery and return to normal activities within a few weeks.
The size of the incision means there is reduced pain from scar tissue and also less blood loss.
Disadvantages for patients
Robotic surgery may not improve the risk for complications from operations, even when the hospital stay was reduced.
A study published in the Journal of American Medical Association of more than 260,000 hysterectomy patients found there was no significant difference in complications and blood transfusion rates for patients who received robotic hysterectomies.
