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New Hampshire to Join Chorus of Concern About Robotic Surgery

Apr 5, 2013

The New Hampshire Board of Medicine is adding its voice to the growing chorus of critics addressing robotic surgery, which has grown into one of the healthcare industry’s hot-button issues.

The state's Board of Medicine is expected to start a discussion in the next week regarding its concern that complications from robot-assisted surgery are on the rise nationally, the New Hampshire Union Leader reported.

The robotic surgery category consists of products manufactured by one company, Intuitive Surgical Inc., which uses the da Vinci brand for its robotic surgical systems – the only such products to have been cleared in the U.S. for soft-tissue surgery. Models in the da Vinci line can cost hospitals anywhere between about $1.5 million and $2 million.

The number of injuries related to robotic surgery is indeed on the rise, to the extent that the U.S. Food and Drug Administration (FDA) has already begun investigating the devices.

In addition, the American Congress of Obstetricians and Gynecologists (ACOG) recently issued a statement about the da Vinci surgical robot, highlighting how little evidence there is to suggest that the device is as effective as other procedures for performing hysterectomies – only one of the many procedures that the products are said to be capable of performing.

Massachusetts health officials are also calling on their state to advocate for better training for doctors, as well as deeper disclosure regarding the potential risks of robotic surgery.

Massachusetts’s Board of Registration in Medicine noted in a statement on its website that “an increasing number” of reports of patient complications related to robotic-assisted surgery has been accumulating over the past two years.

“Risks for robot-assisted surgery should be thoroughly explained” to patients, the board said in its statement, noting that, according to a Bloomberg report, the explanation should include information regarding precisely how much experience a surgeon has performing a particular robotic procedure.

This goes against the grain of how hospitals typically inform potential patients about robotic-assisted surgeries. Hospitals often turn to their websites to discuss this type of surgery, and often focus exclusively on the benefits, according to a 2011 study in the Journal of Healthcare Quality, as reported on by Bloomberg.

The da Vinci’s top-touted benefits are that it delivers less invasive surgery while offering a conspicuously shorter recovery period for the patient compared to what would follow regular manual surgery.

The Journal of Healthcare Quality study found that 86 percent of the hospital websites that spotlighted robotic-assisted surgery claimed that this type of surgery was superior – and not one hospital described a single one of the risks of using the robotic surgical method.

Hospitals could use information from Massachusetts health officials to balance out their prettified da Vinci websites.

The board, in its website statement, listed examples of specific complications that have developed in the wake of robotic surgery. One pertained to the discovery of rectal tissue inside a person’s abdomen after a procedure for ulcerative colitis; another had to do with a patient undergoing a robotic-assisted hysterectomy and ovary removal, only to experience damage to the bowel and left ureter, which created the need for numerous corrective treatments.

While cost, usefulness and safety are all subjects of debate regarding Intuitive’s da Vinci robots, training remains the major issue.

Intuitive Surgical is facing an accrual of lawsuits specifically charging it with failing to provide sufficient training for the doctors who use its robotic systems.

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