Concerns Raised Regarding Robotic Surgery Safety

When it first entered the medical marketplace, robotic surgery was widely hailed as being the next frontier in medical technology. Proponents argued that this innovative approach to performing laparoscopic procedures would reduce the risk of complications to the patient, speed up recovery time, and even reduce post-surgical pain (which would presumably also reduce dependence on powerful narcotics). Now that the honeymoon period is over, increasing numbers of critics have raised concerns about the safety profile of the technology and whether it’s really worth the investment, given the questionable cost-benefit analysis.

Questions about the safety of robotic surgery

The safety questions regarding robotic surgery primarily involve the safety of the equipment itself and the training of the surgeons who use robotic devices. Patient advocates have pointed to troubling complications, such as serious damage to nearby bodily structures. One study that took a closer look at complication rates of robotic surgery vs. non-robotic laparoscopic surgery was published in the journal Obstetrics & Gynecology in 2014. The lead study author, Jason D. Wright, is the chief of gynecologic oncology at Columbia University.

The researchers analyzed data from 87,000 women who went to different hospitals around the country for the removal of ovarian cysts and/or ovaries between 2009 and 2012. The researchers noted that during this time, the use of robotic surgery increased from 3.5 percent to 15 percent of ovary removal surgeries and from 2.4 percent to 12.9 percent for ovarian cyst removal. The results indicated that 7.1 percent of patients who had their ovaries removed with robotic surgery reported complications, including serious damage to the kidneys, bladder, and other structures.

In contrast, only six percent of patients who underwent laparoscopic surgery without robotic devices reported complications.

Between 2000 and 2013, surgeons performed 1.74 million robotic surgeries in the U.S. alone. During this time, there were at least 144 deaths reported that were attributed to robotic surgery complications. Although it’s important to note that any type of surgery carries inherent risks and some of those deaths may be attributable to the general risks of surgery, this is likely to provide cold comfort for the surviving family members of those who lost their lives.

Critics have called for more rigorous training initiatives for the surgeons who use the equipment. “It’s up to each and every health care facility that has a robotics program to develop their own procedure-specific training,” said Christopher Schabowsky of ECRI Institute.

Critics have also noted that Intuitive Surgical, the maker of the popular da Vinci robot surgical system, is facing upwards of 100 product liability lawsuits from plaintiffs who allege serious injury or wrongful death. Intuitive Surgical noted that many problems arose from a mechanical issue that has since been reportedly resolved.

Troubling trends regarding the cost of robotic surgery

The other major concerns regarding robotic surgery involve the cost of the equipment and the procedure. In 2013, the then-president of the American College of Obstetricians and Gynecologists called this type of surgery “the most expensive” way to perform a hysterectomy. The additional cost to remove a uterus with robotic surgery is approximately $2,000, on top of the usual costs of the surgery.

Critics of the robot-assisted system and patient safety advocates have argued that the additional costs to patients and the healthcare system as a whole simply aren’t worth it, given that the evidence regarding the safety profile of robotic surgery is far from conclusive.

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