Robotic surgery of colon costly, shows 'no benefit'

Patients who undergo robotic colon surgery fare about the same as those who have minimally invasive laparoscopic surgery--but their bills are much heftier, according to research from Johns Hopkins University School of Medicine.

"The true test of something new in medicine should be: Is it better? Is it safer? Does it save money? If not, then we probably shouldn't be using it," Nita Ahuja, M.D., an associate professor of surgery and oncology at medical school, says in an announcement. "What we have found is that the robot is no better than laparoscopy and it costs more. It has no benefit."

Based on data from 244,129 colectomies, they found similar complication rates, mortality rates and length of hospital stays between laparoscopic surgery and robotic surgery. However, the robotic surgery cost an average of nearly $3,000 more ($14,847 vs. $11,966) than laparoscopic surgery.

The study, published at JAMA Surgery, also compared results of open surgery as well. Open surgery was done on 51.7 percent of patients, laparoscopy on 47.6 percent and robotic surgery in just 0.7 percent of cases. This study also found laparoscopy was associated with a lower mortality rate, complication rate, shorter hospital stays and lower costs than open surgery.

Ahuja conceded that younger, healthier patients might be chosen for laparoscopy and robotic surgery, which could skew the results.

Johns Hopkins research previously found complications from robotic surgery are widely underreported. The researchers said a "slapdash" system of reporting complications paints an unclear picture of the safety of robotic surgery. A special report from FierceHealthIT included robotic surgery as one of the most overrated, overpriced technologies in November. 

In March, the American Congress of Obstetricians and Gynecologists said that robotic surgery for hysterectomies should not be a first or even second choice for women undergoing routine procedures, due, in part, to the learning curve associated with the robotic system.

The rise in reported adverse events associated with the da Vinci robots could mean more training is in the offing, Bloomberg reports. As of Nov. 3, the U.S. Food and Drug Administration had received close to 3,700 adverse event reports in 2013, more than double last year's report total.

To learn more:
- find the announcement
- read the abstract

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