Concerns over Robot-Assisted Surgery to be Reviewed by N.H. Bd. of Med.

Healthcare officials in New Hampshire are launching an investigation into the possible risk of complications from robot-assisted surgery, including those performed with the da Vinci surgical robot. 

The New Hampshire Board of Medicine met on Wednesday to discuss the risks and benefits of robotic surgery and whether the board should issue an advisory alerting physicians and patients in that state to the potential risks. Details of the meeting have not been released.

The investigation follows an advisory issued by the Massachusetts Board of Registration in Medicine last month, which highlighted concerns surrounding robotic surgery and indicated that doctors and hospitals should closely study the risk of complications following procedures involving use of a remotely-controlled robot, which have been linked to an increasing number of injury reports.

New Hampshire officials say they have received no complaints regarding the da Vinci Surgical System, the only approved robot-assisted surgery device in the U.S., but noted that concerns have been elevated nationwide.

Lack of Training, Rush to Use Cited As Concerns with da Vinci Robotic Surgery

The da Vinci Surgical System is a complex robot that has been heavily marketed and increasingly used in recent years for a number of surgical procedures to provide a less invasive surgery, which reduces recovery time. The device is controlled by a surgeon looking at a virtual reality representation of the patient’s internal organs and manipulating its four metal arms with hand and foot controls.

Since its introduction in 2000, use of the da Vinci robot-assisted surgical system has increased dramatically amid aggressive marketing and promotions by the manufacturer, Intuitive Surgical. The da Vinci costs between $1 million and $2.25 million for a hospital to purchase, depending on the model. It then costs another $140,000 a year in maintenance and between $1,500 and $2,000 for replacement parts after every surgery.

Many doctors and hospitals have reported feeling pressured to have the device to stay competitive with other facilities that offer it, but they also were then in a position where they were pressured to start using it as often as possible to make up for the costs.

There are increasing concerns that many hospitals are recommending robotic surgery without sufficient training and experience, and some have accused Intuitive Surgical of overmarketing it without providing adequate training on its use.

A growing number of reports of da Vinci complications include complaints of accidental burns to internal organs, as well as punctures and tears. Some cases report surgical tools falling off of the da Vinci and getting lost in patients’ bodies, doing severe damage and requiring additional surgery.

The Massachusetts advisory came shortly after the American Congress of Obstetricians and Gynecologists (ACOG) issued a report recommending against robotic hysterectomy surgery, indicating that there is a lack of evidence showing any benefit to patients compared to other means of doing a hysterectomy, yet there are increased costs and a serious risk of complications.

The stock price for Intuitive Surgical, the manufacturer of the da Vinci robot, has fallen dramatically over the past two months, and several financial analysts have predicted that the value of the company will fall even further as more information surfaces about the risk of problems with their main product and as the number of the number of da Vinci robot surgery lawsuits continue to be filed on behalf of consumers who have experienced problems.