The DaVinci Robot – Dr. Lackore
- NOT been shown to improve any key outcome?
- NOT been shown to reduce bleeding, pain or speed recovery?
- NOT been shown to save time or reduce costs?
All of the above is sadly true about DaVinci Robotic Surgery.
On average, It also takes nearly an hour longer AND costs nearly $3,000 MORE .
the DaVinci Robot has NOT
been shown to improve outcomes.
Powerful 2013 statement from the AAGL*: American Association of Gynecologic Laparoscopists “The available evidence indicates that robotic-assisted and conventional laparoscopic techniques for benign gynecologic surgery are comparable regarding perioperative outcomes, intraoperative complications, length of hospital stay, and rate of conversion to open surgery. However, published reports demonstrate that robotic-assisted laparoscopic surgery has similar or longer operating times and higher associated costs” link to the full AAGL* article
CONCLUSION: “Researchers who are not biased by marketing or profit motives have found VERY LITTLE BENEFIT to Robotic surgery over Advanced existing techniques performed by an experienced freehand laparoscopic surgeon.”
MORE THOUGHTS: It is reasonable to worry that the DaVinci Robot is being used for marketing purposes by both Hospitals and Physicians trying to gain patients (market share) at the expense of providing a balance of BOTH the most effective and efficient approach. This was the case when the laser was introduced to Gynecology in the mid 1980s. The LASER was used for marketing purposes. Now we infrequently use the LASER in GYN because it is generally an inferior technology when compared to Harmonic Scalpel, Ligasure tissue fusion devices and others.
Of Course THE DaVinci Robot is NOT all bad.
The DaVinci Robot may be helpful/justified for:
A subset of especially demanding Advanced laparoscopic surgeries including:
… Pelvis frozen by endometriosis (less than 1 in 200 cases).
… Invaisive GYN Cancer – you are referred to Gyn Oncologist
… Certain mesh procedures (if your willing after all the lawsuits).
… A Morbidly Obese Patient / a Giant Fibroid Uterus
THE FUTURE: With time, evolution of techniques, training and experience, we may define an appropriate small group of procedures that actually benefit from using a Robot. In the meanwhile ask tough questions. Is the DaVinci Robot being used because: