Questions About Robotic Surgery Emerge

Questions About Robotic Surgery Emerge

August 16, 2019PAO-M08-19-NI-022

Many hospitals are adding the technology, but perhaps too quickly.


Surgery is a critical service provided by hospitals, and one of the recent developments in the field is the advent of robotic surgery systems. Many hospitals have been investing in the technology in order to offer the state-of-the-art technology. But it remains unclear  whether doing so is the best move for patients.


From an economic standpoint, robotic surgeries tend to be more expensive (in one case, over 1.5 times as much for hernia repairs), yet hospitals generally are reimbursed by insurance companies at the same rate as conventional surgeries. As a result, using the technology can contribute to higher healthcare spending and, in some instances, prevent hospitals from investing their resources in other important areas.


Second, the rapid adoption of robotic surgery systems is, in general, outpacing the development of training and the credentialing standards for the surgeons who use them, according to the ECRI Institute, a nonprofit that studies safety and cost-effectiveness of medical interventions.

There has yet to be clinical evidence released that proves robotic surgeries provide better results than conventional surgeries. Robots are typically marketed as a way to add minimally invasive surgery capabilities that lead to better outcomes, but these claims have not been proven for hysterectomies, and cancer surgeries. The U.S. Food and Drug Administration has also issued a safety notice about the use of robots.


A small randomized clinical trial is currently underway to compare robotic hernia repair with conventional laparoscopic surgery, with results expected by the end of 2019. Larger, longer-term studies are still needed to provide a definitive answer.


These issues have led to questions about free hernia screenings with robotic surgery demonstrations being offered by hospitals around the country. These hospitals say that the screenings provide valuable education about treatment options for a condition that affects approximately 1.6 million Americans each year, about one-third of which are repaired surgically.


There has been no research on the impact of hernia screenings, and some experts are concerned that they could lead to unnecessary surgeries, particularly screenings during which the da Vinci robotic surgery devices made by Intuitive Surgical are showcased. Complications from hernia surgery are common, with just over 10% of patients left to deal with chronic pain that can be debilitating, according to one study from 2016. In many cases, people with few symptoms are better off watching and waiting, rather than having surgery ─ a recommendation typically not included in most hospital screening announcements.


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