The jury is still out on whether robot-assisted prostate surgery produces better outcomes than open or traditional laparoscopic surgery, but the growing popularity of robotic procedures suggests some doctors and patients have already rendered a verdict in favor of the new technology.
Intuitive Surgical, manufacturer of the da Vinci surgical robot, says 86% of men who had prostate surgery in the United States last year had a robot-assisted procedure; 8 years ago, less than 5,000 men had robotic operations. Marketing has played a big role in the rise of robotic surgery, according to a New York Times report that notes some physicians, hospitals and even patients have become "passionate advocates" of robotic surgery, assuming that because the technology is new, it must produce better outcomes.
So far, however, no major studies comparing robot-assisted and traditional laparoscopic surgery have been able to prove that the robot produces superior results. The most recent large, national study compared laparoscopic — both traditional and robotic — to open surgery for prostate cancer and found that while the former shortened hospital stays, it increased the rate of some complications, including incontinence and erectile dysfunction.
Despite the lack of evidence, the reports notes that facilities that invest in the technology, priced at $1.39 million plus $140,000 a year for service, have a financial incentive to use it. Meanwhile, patients are increasingly demanding robotic surgery over traditional methods.
Urologist Jeffrey A. Cadeddu, MD, of the University of Texas Southwestern Medical Center in Dallas, says he's lost patients because he was trained to perform prostate surgery using traditional laparoscopy. "Patients interview you," he tells the Times. "They say: 'Do you use the robot? OK, well, thank you." Dr. Cadeddu says he's begun offering robotic surgery in response to this demand from patients.
Irene Tsikitas
