Study on Robot-Assisted Prostatectomy Errors
The Da Vinci robotic arm, once touted as technology’s one-up over laparoscopic surgery, has come under recent fire for carrying an uncomfortable failure rate – causing many patients to question whether the minimally-invasive nature of the procedure is worth the added risk of a problem.
According to a study published earlier this month in the Journal of the American Medical Association (JAMA), Da Vinci robotic surgery, when used to perform a radical prostatectomy, enhances the patient’s risk of harm and can potentially cause life-threatening mishaps during the procedure. The details of the study, outlined below, were published on July 2, 2014 following a study at the University of California, San Diego.
JAMA study shows increased risk of surgery errors in prostatectomy patients
A prostatectomy is a medical procedure performed on male patients for purposes of removing the prostate and surrounding tissue – usually to remove cancer. Like many other surgeries favored by Da Vinci-savvy surgeons, prostatectomy surgery involves a very small incision in the lower abdomen. From there, the doctor is able to direct the robotic arms from a console located on the opposite side of the room. Tiny cameras on the Da Vinci components allow the doctor to view the patient’s organs and tissue, as well as remove unwanted masses and, ultimately, close the incision.
The problem with this new technology is that it currently carries a significant risk of mishap in prostatectomy patients, and its risk factors when used to perform other types of surgery are still unknown. According to the results of the study, prostatectomy patients are twice as likely to endure surgery errors as their laparoscopic counterparts – odds that would place even the most confident patient ill at ease.
The study included patients who endured the radical prostatectomy procedure between January 1, 2003 and December 31, 2009, involving 401,325 patients overall. According to the results, twice as many patients exhibited some form of safety risk when compared with those who underwent the traditional prostatectomy procedure. In teaching hospitals, the risk of surgery errors almost tripled.
Surgery errors may decrease with additional training
Experts on the issue point to the exponential increase in robotic surgeries following the introduction of the Da Vinci model, likely due to the penchant by some surgeons to rely on the latest and greatest technologies when treating patients. The reality, however, is that some doctors who use the Da Vinci system on a regular basis have not submitted to thorough training and education on the proper use of the system, inevitably resulting in higher error rates.
In 2013, a similar study was performed at Columbia University involving the records of over 264,000 women who had hysterectomy surgery for non-cancerous issues across 441 hospitals in the United States. The study spanned a time period from 2007 to 2010 when robotic surgery rose from 0.5% of hysterectomies to almost 10 percent. This study revealed that the rate of error following robotic versus laparoscopic procedures was nearly identical – however the cost to perform the robotic procedure was about 25 percent higher than traditional or laparoscopic methods. A separate study of hysterectomy procedures revealed that the robotic process takes about 77 minutes longer, on average, than the laparoscopic procedure.
