6. Robot-Assisted Surgery
An "aggressive" competitor to the da Vinci surgical robot is coming in the form of "The Amadeus Composer" and is "smaller and sleeker," with four "snakelike" external arms for improved dexterity, the institute's report says. This may tackle a chief complaint about the da Vinci, which is that it doesn't provide tactile feedback when cutting or suturing tissue.
But ECRI's experts are cautious about robotic surgery, which costs $3.5 million over a five-year period for the da Vinci. "Despite a lack of definitive evidence for the superiority of robot-assisted surgery compared to traditional laparoscopic surgery for many applications, steady growth in both types (general and oncologic) and numbers of robotic procedures continues," the report says.
Still, questions remain about clinician learning curves, the ideal training program, the number of procedures required to maintain operator proficiency, and what criteria to use to credential surgeons who use these systems.
"The high cost and lack of additional reimbursement associated with the use of surgical robots continue to make this technology financially challenging."
The report concludes that while robotic surgery may improve visualization and precision, "the real unanswered questions are how much value they add and, more importantly, how and when will they definitively improve patient care and long-term outcomes?"
7. New Cardiac Stent Developments
New stents and balloons to treat coronary artery disease include those with antibody coatings, bioabsorbable stents that stay in place and then disappear, stents designed to treat bifurcated lesions, and drug-eluting balloons.
"Stent manufacturers are also pursuing low-profile, very thin, and flexible stents intended to minimize stent thickness using newer alloys that enable these stents to maintain sufficient radial support of the artery."
8. Ultrahigh Field Strength MRI Systems
The most-common strength of diagnostic MRI today is 1.5 Tesla, but in recent years, new systems have offered 3 Tesla, with the promise of better images but cost $1 million more.
ECRI issues a few cautions about buying these systems. Reimbursement is the same, regardless of field strength. Use of 3T MRI can either increase image quality or decrease study time, not do both. And these systems "are more susceptible to certain artifacts, which require training and experience to control," and there are patient safety concerns, such as incompatibility with some implants and patient overheating.