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Pros and Cons of Robotic Surgery

Monday, March 3rd, 2014

If you need surgery, you are likely to be presented with the option of robotic surgery. This means that instead of the surgeon working on you directly with his hands, he or she will manipulate a set of robotic arms with surgical instruments attached from a console. Should you go along with this, or should you question the practice?

It would be understandable if you were hesitant. Thanks to the media’s love of a good horror story, most people have heard of instances where patients were accidentally injured – or worse – during robotic surgery. Even the American College of Obstetricians and Gynecologists maintains that robotic surgery is neither the best nor the most cost-effective approach to hysterectomy.

Does this mean that you should flatly reject robotic surgery? Not necessarily. Like any surgical instrument, a robot is as good as the surgeon using it. Furthermore, every patient profile is different. There are a number of considerations for anyone making a choice about robotic surgery.

In 2000, there were (worldwide) only 1,000 robotic surgeries. Last year, there were 450,000. Proponents of the practice say its benefits are responsible for its rising popularity. Less blood loss, less need for pain medication post-surgery, and shorter hospital stays are among these benefits, along with smaller scars (which is also a benefit of laparoscopic surgery). Robotic procedures are less taxing for surgeons, who don’t need to bend over an operating table, but instead, can sit at a console viewing the surgical field on a screen.

But some feel that robotic surgery does not offer significant benefits beyond those of laparoscopic or other types of surgery, and that the “wow” factor is one of the real reasons robotic surgery is catching on. In our love affair with new technology, it’s possible we have a tendency to move ahead too fast without enough standardized evaluation. To be sure, any new medical technology requires proper patient selection as well as a full explanation of all options and their risks and benefits for informed decision making.

What Does All of this Mean for You?

The wisest approach for a patient who needs surgery is to make sure to get an explanation from the surgeon about possible procedures, including what to expect in the postoperative period. The surgeon should also explain why he or she feels that a particular method is the best option in an individual patient’s case. There is no one-size-fits-all when it comes to surgery.

Another consideration is the cost of the surgery. Robotic procedures tend to cost more, but the patient may end up spending less overall. The need for longer hospital stays and pain medications is potentially lower with robotic surgery, and patients might have a lower chance of being readmitted for complications, all things which can lower a patient’s total costs.

For now, robotic surgery appears safe and effective, but it remains just one of the options available to patients. Ask your surgeon about his or her experience with any procedure he or she wants to use, and about complications that have arisen in the past. Remember that the right choice will be different for different people, so talk to your doctor, and let his or her expertise and experience guide you to make the right informed choice for your unique situation.

– Yvonne S. Thornton, M. D., M. P. H.