Is robotic surgery worth the cost?


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8 comments

  1. Andy Smith

    Great overview! Very balanced and objective.

    I especially agree with Dr. Forster’s comments re provincial data. Any special funding for robotic surgery should be tied to accountability on submitting and collating specific data to advance the field in Ontario.

  2. Diya

    This looks very futuristic,but I’m not sure the positive benefits make up for the expense the government or hospitals have to use to make these robots

    • Gerald Goldlist

      If government does not feel something is not FISCALLY worthwhile to govt then shouldn’t patients have the choice to pay for their own care if the patient feels it is fiscally worthwhile to patient?

  3. Nicholas Leyland, MD, Professor and Chair of OB/GYN, McMaster University

    The use of robotic surgery for many surgical indications is a very complex issue. Ultimately, the added value to the system and improvement in patient outcomes must determine whether we can afford to move further in this direction.
    Robotic surgery is certainly “sexy” and high tech, characteristics that are driving the purchase and the use of robots in the USA even in the absence of scientific support. (Donors love this.) Hospitals south of the border must have robotic options or risk the loss of market share in their competitive environment.
    Here in Canada, we have the opportunity and the responsibility to establish the role of any new technology on the basis of high quality, unbiased scientific evidence for positive patient outcomes and cost effectiveness.
    (We cannot lose sight of the value of robotic surgery to the surgeons in reducing the learning curve for less invasive surgery and the provision of ergonomically better options for the doctors.)
    Lastly, conventional laparoscopic surgery can and should be continued to be learned and performed. Surgeons risk the loss of or the failure to develop these skills in many training programs and community hospitals using robots in the USA.
    At the end of the day we ought to approach any new and developing technology with scientific rigor and a healthy, albeit open-minded skepticism.

  4. Dave Anderson

    It amazes me how much technology is growing and advancing year after year. I like that there are now robotics that can help to make surgeries less invasive and more effective. Like you said, robotics are procedure specific and are not possible for all types of procedures. With the robotics procedures in the medical industry increasing, I believe that it will become easier to get cures to diseases in the future.

  5. James Waddell

    This is hardly current reporting as the HQO decision has been made with considerable controversy regarding the result. It would be interesting to have the reasoning behind the decision not to fund robotic surgery in Ontario published here – that would lead to a real “healthy debate”.

  6. Stephen Roedde

    At the risk of providing nothing but a case report, I feel I must weigh in here.
    I suspect, that as implied in the article, the cost-benefit analyses depend primarily on exactly what surgery is being undertaken. Benefits with most abdominal procedures (compared to a laparoscopic approach) are probably nil. Patient benefits with prostatectomies must be balanced against increased hospital financial costs we all bear.

    Recently I underwent a thymectomy via robotics here in Ontario. I was discharged the following day, and was riding my bicycle (with my surgeons blessing) that evening. I was essentially fully functional within 48 hours… and using no analgesics whatsoever. Contrast this with the (probable) system costs (not to mention patient misery) of the same surgery with a sternotomy.
    I cannot speak to how I would fare with a video-assisted approach (presumably a video-assisted extended transcervical thymectomy would be an appropriate comparison)…but this case study has little doubt that there were advantages both to me, and “our system” with robotic thoracic surgery.
    That I had a superb surgeon, incredible nurses, NP’s, XRay Tech’s and physiotherapists both renewed my flagging faith in our “system” and contributed to a rapid recovery.

    We clearly need good evidence for robotics with each indication (or anatomical region). Only then can we move beyond glowing anecdotes like mine.

    That said, I for am happy (and lucky) I did not have to wait for said evidence.

  7. Pamelina

    More relevant research is required over the longer term to evaluate the benefits, or otherwise, of robotic surgery in whatever confition

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