Robotic Prostatectomy May Be Safer Than Traditional, Open Surgery: Study

While serious concerns have surfaced in recent months about the safety of da Vinci robot-assisted surgery, a new study suggests that robotic prostatectomies may reduce recovery time in the hospital and reduce the risk of blood transmission, even though patients may remain on the operating table longer than with traditional, open surgery.

The study was published this month in the medical journal Urology, looking at the outcomes of minimally invasive radical prostatectomy (MIRP), which includes both robotic surgery and laparpscopic surgery, and compared them to traditional open surgery. The findings suggest that together the two techniques could be safer than open surgery.

The findings of this research and others like it could help doctors better determine what surgeries are best suited for use of the controversial da Vinci Surgical System, which is a robotic surgery device that is remotely operated through the use of cameras, remote controls and 3D imagery. In recent months there have been numerous concerns over the widespread use of the robot and whether it may unnecessarily expose patients to increased costs and a potential risk of problems without providing any benefits.

In this latest study, researchers looked at 5,319 radical prostatectomies and compared outcomes between MIRP and open procedures. They found that while operative time was significantly longer with the MIRP group, they resulted in shorter hospital stays and significantly fewer blood transfusions. However, the results look at laparoscopic and robotic surgery as one group. Other studies that have compared the two have suggested that the da Vinci may have higher complication rates.

Other studies for other types of surgeries have led to far different results. Earlier this month a study published in Obstetrics & Gynecology determined that using the da Vinci to perform a robotic hysterectomy is no safer than laparoscopic surgery, but costs thousands of dollars more and increases the risk of postoperative pneumonia. However, there was a slightly less likely need for a blood transfusion.

Another study published this month in the Journal for Healthcare Quality found that there is likely chronic underreporting of da Vinci surgery complications, which could be affecting perceptions of the robot, making it appear safer than it is in reality. The study found that while there have been 245 surgical complications reported, including 71 deaths, that number is likely far too low. The study found that many of the complications were never reported until after they showed up in the media.

 Da Vinci Robotic Surgery Concerns

The da Vinci Surgical System is used for number of different urologic, laparoscopic, gynecologic and non-cardiovascular thoracoscopic surgical procedures and thoracoscopically assisted cardiotomy procedures. The surgical robot has been aggressively promoted in advertisements directed to consumers, promoting the device as a superior alternative to traditional surgery because it is less-invasive and results in reduced recovery time.

As Intuitive Surgical’s $1.5 million robot has been used with increasing frequency at hospitals throughout the United States in recent years, a growing number of reports have surfaced involving individuals experiencing problems following robotic surgery that are caused by burns, tears and other internal injuries. Concerns have also surfaced about whether the robot is over-used and whether it provides sufficient benefits over traditional procedures in many different applications.

Intuitive Surgical currently faces a growing number of da Vinci robotic surgery lawsuits filed on behalf of patients who allege that they experienced problems following their procedure, involving burns, tears and other internal injuries that were allegedly caused by the robot.

In a recent filing with the Securities Exchange Commission (SEC), Intuitive Surgical disclosed that at least 33 complaints have already been filed in state and federal courts throughout the country, and reports suggest that hundreds of additional cases may be brought in the coming months and years.

Intuitive Surgical also faces a number of shareholder class action lawsuits over the da Vinci, which were brought on behalf of investors who allege that the company has withheld information about the safety of the robotic surgery system and minimized reports of serious complications experienced by surgeons during or shortly after the procedures.

The only da Vinci lawsuit to reach a jury so far ended in a defense verdict in May 2013. However, according to the company’s SEC filing, that plaintiff is planning to appeal the decision.