In a study presented by Ms. Postoev and colleagues at the ACS Clinical Congress on a cost-benefit analysis of robotic vs. laparoscopic colectomy, she found little difference in clinical outcomes but higher costs as a result of added time needed to prepare the robot for surgery.
“Most of the data that I’ve seen, and it’s frequently discussed in surgical meetings, is whether or not the difference in robotics is sufficient to justify the cost,” Dr. Hughes said. “It is a terrific marketing tool in the sense that you can certainly attract a lot of people to a hospital with robotic surgery, but whether or not those outcomes are truly different and the cost of those outcomes are justifiable is yet to be determined.”
In the education ranks, students are seeing robotics more often as well.
“Everybody is going toward robotics,” Ms. Postoev said in an interview. “It’s much easier for a new surgeon to use than laparoscopic” surgery.
The ease of use of robotics, however, could end up being a double-edged sword, particularly if there are areas of the country where robotics may not be as pervasive, or in cases when a conversion to open surgery might be required.
“It is a real concern that trainees are being taught robotic surgery for what is not really needed to be robotic in mainstream,” Dr. Hughes said. “Then they come out with less experience with straight stick laparoscopy and we’ve certainly seen lots of problems in the laparoscopic range for people once they get to the point that they have to convert to open. We really don’t have a large volume of trainee experience in complex open surgery. That’s a big problem. Robotics certainly isn’t going to make that a lot better.”