New Concerns on Robotic Surgery Costs, Complications

September 10, 2013 — Hysterectomies performed using the Da Vinci Surgical Robot add thousands of dollars to the cost of surgery without providing any benefit over traditional minimally-invasive surgical methods (laparoscopy), according to a study published in the October issue of Obstetrics & Gynecology.

The researchers analyzed data on over 800,000 hysterectomies performed in 2009 and 2010, of which 5% were performed robotically and 20% were performed laparoscopically. Complication rates were similar for robotic and laparoscopic surgery, at about 9%, but the average cost of robotic surgery was $2,489 higher.

Other Studies Confirm Higher Costs, No Benefit

Earlier this year, a study published in JAMA found similar results — robotic hysterectomies were an average of $2,189 more expensive, but did not reduce complication rates compared to laparoscopic surgery.

The use of surgical robots has skyrocketed in recent years. The percentage of all hysterectomies performed with the robot increased from 0.5% to 9.5% from 2007 to 2010. However, as the popularity of robotic surgery has increased, concern about under-reporting of adverse events has also grown.

Robot Surgery Complications “Vastly Underreported”

Studies showing similar complication rates from laparoscopic surgery and robotic surgery may not be accurate, because adverse events associated are “vastly underreported,” according to a study published last week in The Journal for Healthcare Quality.

At least 26 robotic surgery lawsuits have been filed by people who were injured. Plaintiffs claim that Intuitive Surgical, the manufacturer of the Da Vinci Surgical Robot, has used aggressive marketing tactics to sell the $1.5 million robots while failing to adequately train doctors or warn patients about the risk.

One example cited by the New York Times is a lawsuit filed by Erin Izumi, a woman from Washington. She suffered intestinal lacerations during an 11-hour robotic surgery to treat endometriosis. Although she was hospitalized for five weeks and required multiple operations to repair the damage, her injury was not reported to the FDA until after she filed a lawsuit. The hospital settled her claim in May 2012.

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