There are many reasons why the cost of health care simple and straightforward in this country continue to increase while the quality and the imputed value not keep up with the major industrial countries step. But as a surgeon, I have an answer in one word for all that is wrong with "robot" of health care.
The estimated 1.2 to 2,500,000 $ operation cost each robot to the maintenance cost of $ 125,000 equivalent per year, are the ultimate choice in luxury hospital shelves. Radical prostatectomy, hysterectomy and cholecystectomy to justify the purchase of a robot requires, but is not necessarily the problem. A surgical robot is a marketing tool, and even if not supported hundreds of cases robot requires a hospital to the cost of owning a cover, the marketing of surgical robots consumer sends a message. If you know what want the best hospital in the city, follow the robot.
I have no doubt that in the right hands and for the right indications, surgical robots are tools that thousands of people to help superlatives, but there's a problem. No one seems to exactly what the robot adds agree that more benefit from its use.
Robot advocates believe that patients who lost the robotic surgery with smaller incisions and less blood to undergo, and that these measures will lead to less pain, shorter hospital stays, and perhaps a return to work faster. However, laparoscopic surgery, minimally invasive technique provides substantially the same advantages.
If you take a closer look, several surgeons have little time, there is little evidence that robotic surgery offers an advantage over laparoscopic surgery for the average patient. The most recent study, a randomized study in the New England Journal of Medicine, Cancer Center, Memorial Sloan Kettering published, found no significant benefit in reducing surgical complications and hospitalizations.
In a previous retrospective study, researchers at Columbia University examined the records of 264,758 women who underwent laparoscopic hysterectomy for benign disease or robots or had undergone from 2007 to 2010, a time in which the robotic surgery increased from 5 percent to nearly 0 10 percent of all hysterectomies. The complication rate was again the same for both groups.
The authors of both studies concluded that the continued evaluation of new technologies is performed before surgical widespread acceptance.
"More technology does not necessarily mean better health care," said Dr. Martin Makary of Johns Hopkins University School of Medicine potential complications of robotic surgery. Dr. Macario expressed concern that many surgeons. A robot can not feel the tissue of a patient and that the loss of touch input leads as a surgeon delicate maneuvers could cause damage to organs accidentally injured. Dr. Macario has been a study in 2013 published in the Journal of Quality Health conducted, found several cases of complications, the robots have emerged in the media, not reported to the FDA before the articles were published in the press. With incomplete and inaccurate with respect to data performance of the robot, it is difficult to assess the safety of robotic surgery.
We know robots additional cost. In the study by Columbia University carried out, for example, the average cost to the hospital for a robotic hysterectomy was $ 8,868 to $ 6,679 compared to laparoscopic surgery.
"We have not developed the robots compete with laparoscopic surgery," Dr. Myriam Curet, medical advisor of Intuitive Surgical, said, referring to the study of hysterectomy.
But it is true that the robot was not designed to compete with a laparoscopic operation (750,000 per year) surgeons will be more distributed for the removal of the gall bladder, one of the most common laparoscopic surgeries USA experts can in 45 minutes or less make? Who decides which procedures should be followed if one will cost at least a third more and has not been studied enough to determine the benefits and risks?
I'm not anti-technology. I saw some amazing new medical devices in the last ten years, but the controversy robot shows what I think is the problem of our health care system. We, the doctors and hospitals to embrace the most expensive technology available, not because it will make a significant difference in the results of a patient, but because it bring more business and more money to be.
How can we tame the costs of health care in this country? By tracking all the robots in our system and to tame.
Catalina Musemeche is a pediatric surgeon and author of Klein: Life and Death at the forefront of pediatric surgery.