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JAMA study: Surgical robot adds little to hysterectomies other than price

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Using an Intuitive Surgical ($ISRG) robot for hysterectomies costs hospitals nearly $2,200 more per procedure compared to nonrobotic, minimally invasive surgical approaches, but patients didn't gain any added benefits, researchers from Columbia University and elsewhere have concluded.

Bloomberg highlights the findings, which are published in detail in the Journal of the American Medical Association. The research comes out at an interesting time in healthcare as well. With the Patient Protection and Affordable Care Act well under way, device and surgical toolmakers are gaining more traction these days if they can prove that their products not only boost the standard of care but also add value and positively address escalating healthcare costs. And Intuitive, maker of da Vinci surgical robots as well as related devices and instruments, was quick to respond.

"The message I get from this paper is with the advent of robots you are seeing more patients being done minimally invasively and that is good," Myriam Curet, Intuitive's chief medical adviser, told Bloomberg in a telephone interview. But as the article notes, she also knocked the cost analysis for not addressing two elements: robotic potential advantage in areas such as hoping women recover sooner, and whether robots allow surgeons to switch less frequently to open surgeries.

For the study, the researchers looked at hospital data from 2007-2010 covering 264,758 women across the country who had hysterectomies for benign conditions. They found that surgeries involving Intuitive's $1.45 million surgical robot soared from 0.5% of hysterectomies in 2007 to 9.5% in 2010. But the data suggested no change in the rate of complications, despite the extra cost--$2,189 more compared to a traditional minimally invasive surgery that used laparoscopy rather than a robot. Specifically, a robotic hysterectomy generated a 5.5% complication rate, versus 5.3% for laparosopic surgery, according to the story.

At the same time, however, the study showed that fewer women were dealing with open surgeries for hysterectomy, which involves removal of the uterus through a large abdominal incision.

- read the Bloomberg story
- here's the JAMA journal abstract

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