Da Vinci Robotic Surgery getting popular despite costs

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Surgeons performing Da Vinci Robotic Surgery at Wesley Medical Centre in Wichita, Kansas. Photo - Wesley.ehc.com

A recent study has found that, patients who have robot-assisted surgeries on their kidneys or prostrate have shorter hospital stays and lower risk of having blood transfusion or dying, but the bill is significantly higher.

Analysis which appeared in the Journal of Urology compared increasingly common robotic surgery to other surgery techniques and found that direct costs can be up to several thousand dollars higher for the robotic surgery.

The robotic surgery has replaced the surgeons’ hands with ultra-precise tools at the end of mechanical arms, all being operated by the surgeons from consoles. It is being touted as less invasive and efficient and uses “keyhole surgery” in which tiny video and tools are being inserted in the body for surgery.

Jim Hu, study leader at Brigham and Women’s Hospital said: “I think the take home message is that robotic surgery, looking at our study, had certain beneficial outcomes compared to open and laparoscopic procedures.”

To make things clear, Hu and his team analysed surgery data from the national government database to see if the costlier robotic surgeries were cost effective with extra benefits over older techniques.

According to the recent data, more than half of all prostate removals involved robot-assisted surgery. About 3% of prostrate patients had standard laparoscopic surgery and 44% patients had open surgery.

However, open and laparoscopic surgeries are still more common than robotic surgeries for kidney repairs and removals. If reports are to be believed, none of the patients who went through robotic surgery for prostrate removal died during or after the surgery, whereas two out of 1,000 died after an open procedure.

About 5% men who had open surgery needed blood transfusion, compared to 2% men who had robot surgery. Open surgery patients also had to stay for longer time in the hospital.

David Penson, surgeon at the Vanderbilt University Medical Center, said more consideration should have been given to the state of patient afterwards. Emphasis should be limited on procedure as opposed to surgical skill, he said.

“Years ago, this was thought to be the be-all-end-all operation, particularly with prostate surgery. We were going to get patients out of the hospital quicker, have better potency and incontinence outcomes,” the medical professional said in an interview.

“And the reality of it is that, there are some benefits but not as much as we had hoped,” he added.

ROBOTIC SURGERY IN INDIA

In India, prostate robotic surgery is set to offer good solutions in the coming years. In fact, it is being considered as the latest weapon in India to fight ailments. Presently, there are some top-notch hospitals in India where this surgery is being offered.

Prostate cancer is usually seen in men when they reach to the age of 50, and India has more such patients compared to other parts of the world. Moreover, this treatment overpowers the financial burden on insurance companies.

However, there are some countries where this robotic surgery hasn’t been used, including countries like Singapore, because of the huge maintenance costs and expenses.

According to the research from Peter MacCallum Cancer Centre in Melbourne, Australia, the robot costs at least $2.6 million to install, $1,45,000 a year to run and $2,200 extra for each surgical case meaning the procedure is prohibitively expensive for many hospitals and countries.

SURGEONS’ ADVANTAGE

In many countries, surgeons are actually using it as the tool to operate cancer patients. Prostate robotic surgeries are becoming increasingly popular as they are less traumatic and quick compared to open surgery.

Robot assisted surgery which is also called ‘da Vinci Surgical System’ is being used in almost 200,000 operations a year across the globe. Patients who suffer from oropharyngeal cancer also prefer going for robotic surgery because the other option involves a traumatic surgery with a poor survival rate.

Dr. Eric Moore, MD at Mayo Clinic in Rochester said: “We found that with robotic surgery 96% of patients could swallow a normal diet within three weeks of treatment.”

“Continuing research involving multiple medical centers will investigate transoral robotic surgery in a larger population of patients with oropharyngeal cancer,” he added.

Dr. Kazuhiro Yashufuku, thoracic surgeon at Toronto General Hospital said: “Because of the technology that is involved in the robot, it actually enhances the surgeon’s ability to do more precise work inside.”

He also added: “The robotic instrument have the full range of motion of your fingers, your wrist, so that you can actually go around corners.”

FUTURE IN MIDDLE EAST

Middle Eastern countries like the UAE have also seen the rise in robotic surgeries to treat cancers. In 2008, a live robotic surgical broadcast was performed at Rashid Hospital in the UAE as a part of three-day laparoscopic and endoscopic surgical conference.

Prof Rolf Hartung, head of general surgery at Dubai Hospital, said: “The robotic arm will do part of the surgery. It removes the need for a second surgeon in complicated procedures because the robotic arm works as an extra hand.” He added that it would lower the risk of mistakes from trembling, which might occur when a surgeon was tired.

Sources: Gulf news, gloabalregina, qualitysurgeonindia, medicalxpress, Reuters

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