Da Vinci Robot Not Recommended for Some Surgeries

Washington DCThe American College of Obstetricians and Gynecologists has issued a statement regarding the use of the da Vinci Robot for hysterectomies. The organization issued its advice, noting that surgeries involving the da Vinci surgical robot did not appear to be more successful than traditional surgeries. The organization did not note if reported da Vinci robot injuries were a factor in the advice.

Doctors often use robots in surgeries to allow them to maneuver in smaller areas with less severe cuts to the patient. The robot arms, which hold the surgical instruments, are controlled by a computer operated by the doctor. The surgical robot is believed to allow for less invasive surgeries and, therefore, shortened recovery times.

But the American College of Obstetricians and Gynecologists (ACOG) says surgical robots should not be the first or second choice for hysterectomies. The organization noted that the robots are more costly than traditional hysterectomies but do not shorten the recovery times.

“It is important to separate the marketing hype from the reality when considering the best surgical approach for hysterectomies,” ACOG President James T. Breeden wrote in a news release. He noted that expertise with robotic hysterectomy is limited and varies across the health care system. Breeden argued that marketing of the robots convinces patients they are the best choice when traditional or laparoscopic surgeries are better options.

A study published in February 2013 found robotic surgery increases the cost of a hysterectomy by more than $2,000 without adding any benefit for the patient over traditional surgery. The study was published in The Journal of the American Medical Association (2/20/13), and involved analysis of data from more than 264,000 women who had a hysterectomy for benign gynecologic disorders from 2007 to 2010.

Researchers noted that between 2007 and 2010 the use of robot devices increased from 0.5 percent to 9.5 percent of all hysterectomies. They found that although patients who had a hysterectomy involving a surgical robot were less likely to stay in the hospital longer than two days - when compared with women who had a traditional hysterectomy - the rate of transfusions and the rate of discharge to a nursing facility were similar. Despite similar outcomes, surgery with a robot was more than $2,100 more than traditional surgery.

When compared with laparoscopic hysterectomy, researchers wrote, “the robotic procedure offers little short-term benefit and is accompanied by significantly greater costs.”