Every now and then it becomes pretty clear that some new development in medical treatment is a bad, bad idea. Robot-assisted surgery is starting to look like one of those and new research published in the Journal of the American Medical Association adds to that perception. (JAMA Article) The study compared robotic versus laparoscopic surgery for benign hysterectomies. During the period from 2007 to 2010, robot use increased from .5% of hysterectomies to 9.5%. The rate tended to grow dramatically at a hospital once it had a robot, indicating strong pressure to use it once the money was spent, regardless of outcomes. Overall complication rates were essentially the same, but the robot cases cost over $2000 more a surgery. Given the number of hysterectomies, that adds up quickly.
The surgical robots are basically made by one company, which has spent a fortune advertising them and marketing them to patients and physicians, often without mentioning the additional costs they cause or the fact that they provide no real outcomes benefits. And hospitals and doctors who spend a lot of money buying these machines then spend a lot of money trying to get patients to agree to have them used. At least payers have begun refusing to pay anything more for surgery with a robot. You have to wonder where the FDA is and why it hasn’t clamped down on the essentially false advertising being used to sell these machines. Sooner or later, the malpractice lawyers will have a field day with this.