Robot-assisted surgery outcomes better but costlier, study finds

GlobalPost

Patients who undergo robot-assisted surgeries on the kidneys or prostate have a higher survival rate than those operated on by more traditional methods, but end up with a bigger bill, a new study has found. 

Outcomes from the robotic surgery included shorter hospital stays and a lower risk of blood transfusion or death, according to Reuters.

Among the prostatectomy cases, there were no deaths from laparoscopic or robotic surgery, whereas two out of every thousand men died after the open procedure, the study — reported in the Journal of Urology — found.

However, for a prostate removal the cost was between $700 and $1,100 higher than if they'd had standard laparoscopic or open surgery, which cost on average $10,000.

For kidney removal, robotic surgery cost $13,900, $2,700 more than laparoscopic surgery and $1,300 more than open surgery.

Plus, the the study wasn't able to gage less-obvious measures of effectiveness, such as quality of life over the long run, Reuters reported.

Despite the higher cost, robot-assisted radical prostatectomies had become the most common type of surgical treatment for prostate cancer in the US, according to TheCheckup.com, the website of Dr. Harry Fisch, a board-certified urologist at New York Presbyterian Hospital/Weill Medical College of Cornell University.

The site was citing a report presented at the European Association of Urology 27th Annual Congress by the Vattikuti Urology Institute, which included that between October 2008 and December 2009, about 61 percent of prostatectomies in the US were done robotically.

That's compared with 9 percent of prostatectomies carried out robotically in 2003.

Lead author of the most recent study, Jim Hu of Brigham and Women's Hospital in Boston reportedly said: "I think the take home message is that robotic (surgery), looking at our study, had certain beneficial outcomes compared to open and laparoscopic procedures."

According to News24, Hu — who  said his team decided to focus on urologic surgeries because the field had adopted robotic surgery the most rapidly — added that the study was "timely because of spiraling healthcare costs.

"One needs to look more closely at comparative effectiveness to justify the cost of these procedures," he said.

Hu's study also found that open and laparoscopic surgeries were still more common than robotic surgeries for kidney repairs and removals.

Reuters quoted Dr. David Penson, a surgeon at Vanderbilt University Medical Center who was not involved in the work, s saying: "The value of this study is it documents there are some advantages [to robotic surgery]. But we should have done this years ago.

"I think there was excitement in the general population and there was a lot of marketing about robotic surgery ahead of any proven benefit to the procedure."

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