Robot-Assisted Prostate Surgery

A major political and economic issue that is closely tied with robotics in surgery and healthcare is the rising costs of healthcare. Ethically it is in the best interest of the technical and medical communities to provide services to customers and patients at a fair and balanced price. On average robotic surgical systems cost

Al). This includes the increase in dexterity, the restore of proper hand-eye coordination, and improvement of visualization (Meyers et al.). In Cameron Scott’s article from the Healthline News, “Is da Vinci Robotic Surgery a Revolution or a Ripoff?,” he states that robotic devices including the da Vinci surgical device succeeds well in urology and the removal of prostate. Prostate removal is extremely difficult for open surgery practice, however the da Vinci made is easier with about 90 percent of these kinds of surgeries are now done robotically (Scott). Some evidence even suggest that with robotics used in prostatectomy, there is less blood loss, faster recovery, and fewer internal scarring (Scott.). There are many other examples from hospitals and manufactures that support the uses of robotic surgery and its benefits. However, even though these new technologies of robotic devices are supposedly be helping patients and making surgeries less invasive, they are still many concerns of how they should be properly regulated.

One of the most important aspects to any new technique in healthcare is to develop enough information to decide if the benefits outweigh the risks. According to the Wall Street Journal, in 2000, there were only 1,000 robotic surgeries globally. That number increased to 360,000 in 2011 and 450,000 last year (Pinkerton, 2013). Almost all sources, including the da Vinci Surgical System website, have specified that for the patient, who receives robotic surgery, usually experiences less blood loss, a shorter hospital stay and less dependence on postoperative pain medication. There is also a benefit in cosmetics where there is no evidence of big scars since robotic surgery instruments enter through tiny incisions (da Vinci Surgical System, 2015). Benefits related to the surgeon include decreased back pain and greater range of motion and precision. This is because the procedures do not have the surgeons constantly bending over an operating table for however long the surgery would take. According to Becker (2012), the enhanced screen with 3D like image and three interactive robotic arms, all with the capability of achieving range of motion greater than the human

As technology improves, surgical robots are rapidly gaining support among both doctors and patients across America. Today more than 900 hospitals have the da Vinci robot which is double the number in 2007. (Freyer, 2010) Da Vinci robots were first approved by the FDA in 2000 for prostate removal, but now da Vinci robots are used for a variety of other surgical procedures (Freyer, 2010). Robot assisted surgery offers advantages such as smaller incisions, reduced blood loss, less pain and faster healing time (Vijay, 2010), as well as making surgery less demanding for the surgeon. Robotic surgery involves many obvious advantages but the impact of cost, access, and quality must

This includes the increase in dexterity, the restore of proper hand-eye coordination, and improvement of visualization (Meyers et al.). In Cameron Scott’s article from the Healthline News, “Is da Vinci Robotic Surgery a Revolution or a Ripoff?,” he states that robotic devices including the da Vinci surgical device succeeds well in urology and the removal of prostate. Prostate removal is extremely difficult for open surgery practice, however the da Vinci made is easier with about 90 percent of these kinds of surgeries are now done robotically (Scott). Some evidence even suggest that with robotics used in prostatectomy, there is less blood loss, faster recovery, and fewer internal scarring according to reports mention in Eastham’s article (Eastham et al.). There are many other examples from hospitals and manufactures that support the uses of robotic surgery and its benefits. However, even though these new technologies of robotic devices are supposedly be helping patients and making surgeries less invasive, they are still many concerns of how they should be properly regulated.

Robotic-assisted hysterectomy has gained widespread acceptance in many centers since U.S. Food and Drug Administration approval in 2005. Several reports on the early experiences with robotics for endometrial cancer surgery suggest potential advantages over traditional laparoscopic surgery, including improved surgeon ergonomics, high-definition three dimensional visions, and wristed instrumentation that improves surgical precision.10The overall postoperative morbidity and complications inherent in both techniques are nearly the same

The 21st century can rightfully be considered as the era of technology when the new inventions and discoveries will most likely affect all the segments of human life. At this point, some of the breakthrough inventions of our times have been in the medical field. Robotic surgery has become an almost common practice in the advanced medical world and new uses for robotic assisted surgery are everyday set in place. However, such developments also attract different interests and implications.

Robot-assisted laparoscopies were almost twice as likely as traditional procedures to take longer than four hours. And robot assistance boosted the average hospital cost from $16,851 to $19,530 — probably because of extra operating room time and the cost of robot maintenance.

4. David F. Friedlander, Mehrdad Alemozaffar, Nathanael D. Hevelone, Stuart R. Lipsitz and Jim C. Hu. Stepwise Description and Outcomes of Bladder Neck Sparing During Robot-Assisted Laparoscopic Radical Prostatectomy. THE JOURNAL OF UROLOGY. 2012.Vol. 188, 1754-1760.

In 2001, the first case series of robot assisted laparoscopic radical prostatectomies (RALPs) using the da Vinci operating system were reported. Since then its use has grown exponentially, much more so in the US than the UK. Some argue that aggressive marketing by manufacturers, operating preference by surgeons, and high demand from patients have all led the the rapid adaptation of RALP without the same degree of evidence, in terms of high quality randomised controlled trials, as would be expected from other medical interventions. This report will outline the development of robot assisted radical prostatectomy for the surgical management of localised prostate cancer and how it’s outcomes can be compared with other surgical approaches.

The Lancet Journal has published the results of a “randomized, controlled trial that compared robot-assisted prostate surgeries to traditional versions of the procedure.…” The Australian physicians reported that there is no evidence base to “recommend” the da Vinci machine over the laparoscopic alternative. The study found that “at 12 weeks follow-up — there was no significant difference in patients’ sexual function or urinary control,” two variables that are sometimes affected by the surgery (Johnson). There is no reason for patients to think or expect better outcomes in comparison to ‘old-fashioned’ styles of surgery. Additionally, a study published in The Journal of the American Medical Association, juxtaposed 264,758 laparoscopic and robotically assisted hysterectomies in 441 varying. The conductors of the study found “no overall difference in complication rates between the two methods, and no difference in the rates of blood transfusion. The only big difference between the two is the cost–the robotic surgery costs one-third more than laparoscopic surgery” (Rieland). Another study reporting that the outcomes between laparoscopic and daVinci type surgeries are the same. The main reason of support for supporters of robotic surgery is the time decreased

Can robotic doctors do more than we think? Researchers have compared patients who have had traditional laparoscopy surgery have a kidney removed, but then they compared people that have paid a little more for robots to help the doctors with surgery they only make a large incision and they don't have to have one of their kidneys removed. But even though the robotic doctors make only one incision the person who has the surgery has to stay in the hospital the same length of time as well as the people who don’t have robots doing the surgery. Stanford University Medical Center have looked at 24,000 kidney removal surgeries in 416 hospitals across the United States from 2003 to 2015. Patients with cancer that have had conventional laparoscopic

Many patients appreciate less recovery time and less pain post-operation (13). Benefits of robotic assisted surgery include shorter hospital stay,

Leading medical professionals have believed strongly that the public are not receiving enough information to make a decision on having robotic surgery as opposed to laparoscopic surgery. Laparoscopic surgery is performed on the abdomen or pelvis. The promotional materials, researchers report online in the Journal for Healthcare Quality, overestimate the benefits of surgical robots, largely ignore the risks and are strongly influenced by the product’s manufacturer.

One of the problems with innovations in robotic technologies is the rapid pace of development that has constrained the ability of researchers to study these technologies in clinicial settings to determine the efficacy of their use. For instance, according to Hidler and Lum (2008), "Robotic therapies that can be delivered acutely may have the largest effect on function, but studies in this population are relatively rare" (p. vii). Despite this