Robotic Bladder Cancer Surgery No Better than Open Surgery

July 24, 2014 — Using robotic surgery to treat bladder cancer does not reduce the risk of complications, shorten hospital stays, or improve recovery time compared to traditional “open” surgery, according to a study of 118 patients that was published in the New England Journal of Medicine.

Robotic surgery is a type of minimally-invasive laparoscopic surgery. The surgeon sits at a console in the operating room, looks through a 3D viewfinder, and uses joysticks and foot pedals to control four robotic arms that do the cutting. The technology is more precise and less invasive than traditional “open” surgery, which involves larger incisions and a doctor directly handling surgical instruments.

The popularity of robot surgery is booming for bladder cancer patients, with an estimated 15-22% of bladder removal surgeries (radical cystectomies) performed robotically, according to the Wall Street Journal.

Given the hype, researchers expected to find better patient outcomes. Instead, the only difference was that robotic surgery took 2 hours longer and patients bled slightly less. The findings were so clear, the study was stopped early.

Added Costs, No Added Benefits for Patients

The study is sure to raise questions about whether the added cost of robotic surgery is justified. On top of the $1.7 million purchase price for the robot, a study published in the Journal of Urology, in 2010 found that robotic surgery for bladder cancer cost about $1,600 more than open surgery.

Advocates of robotic surgery say the advantages will become more clear as doctors become more adept at working with the robots.

However, this is not the first time doubts have been raised about the advantages of robotic surgery. Last year, a study warned that robotic hysterectomies were $2,200 more expensive but offered no patient benefits compared to open surgery. The authors blamed aggressive direct-to-consumer marketing for a rapid surge in the popularity of the technology.