What's Wrong with the da Vinci Robot?

Joe Cantlupe, for HealthLeaders Media , January 26, 2012

DeFatta isn't the only throat and neck cancer surgeon who is enthusiastic about the possibilities of the da Vinci.

"It is the paradigm shift in our treatment, with minimally invasive robotic surgery that leaves patients with improved ability to swallow and speak and function," Tod C. Huntley, MD, FACS, co-director of head and neck cancer services at St. Vincent's Health System in Indianapolis told me for an article in the January issue of  HealthLeaders Magazine.

Patients are now discharged in less than five days as opposed to multiple weeks of inpatient recovery from the traditional surgery, Huntley says.

In his field, DeFatta says it appears the da Vinci robot will be increasingly put to use in surgeries for obstructive sleep apnea when it is caused by the collapse of the upper airway due to a large tongue base. He says patients that have the TORs procedure typically go home in two to three days, compared to 10 days with conventional surgery.

In ECRI's opinion, the da Vinci is part of potential "costly robot wars" in healthcare. The organization's report says that although proponents tout the da Vinci's improved visualization capabilities, as well as its precision and dexterity, "real unanswered questions are how much value they add, and, more importantly, how and when they definitely improve patient care and long-term outcomes."

While ECRI cites cardiology and other procedures used with the da Vinci, it also mentions head and neck cancer surgery, where doctors say it appears to be opening doors to improve patient care.

But the robots are used in many procedures, and there are still unanswered questions about them, not unlike the incomplete scientific and artistic picture left by da Vinci the man. Despite ECRI's viewpoint, the enthusiasm expressed by certain surgeons using the device show that the full story of the medical robot is still incomplete. Much more needs to be studied, and written.

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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6 comments on "What's Wrong with the da Vinci Robot?"

Kyle (1/20/2013 at 10:07 PM)
I'll tell you what advantage this machine has! Sensitivity and dead zone! I don't care who you are or how experienced you are, you cannot stop involuntary trembling. As steady as your hand is, those small mistakes are like football fields compared to your tissues and cells. I play flight simulators and other video games and dead zone is so very important. Dead zone is configurable feature to every expensive yokes and joysticks that ignore input when it is under a certain limt. When the doc is holding the knife or laser, any movement is cutting you, but with the robot assist, the doc moves their instrument a micrometer the robot can ignore it. Now the involuntary trembles (no matter how small) are in fact eliminated. Now lest say you actually want to make an incision 1 micrometer, that's 1/100ths the width of a human hair, humans cannot make that precise of a cut. With the robot, they can set the sensitivity to such a fine level they have to move the input instrument 10 cm, for the real laser to move 1 micrometer, (factor of 100, 000) as long as a camera can zoom that deep. Now these are just some theoretical ideas, I have no idea if the robot can actuallybe that precise, but now these levels are in view as the technology improves.

Strikermmg (1/20/2013 at 1:00 PM)
There is nothing wrong with the DaVinci Robotic system! It is an amazing piece of technology that has made a paradigm shift in surgery. At its core it is part of a bigger group.of minimally invasive surgery procedures. MIS as a group is far better for the patient and hospital and medical insurance companies. What needs to be differentiated is the choice of methods used in the various procedures being done. In many cases MIS can be done without the DaVinci system with very similar outcomes. Thus costing all parties much less. What also needs to be recognized is that the DaVinci system can do MIS procedures that up until now were only able to be done by open surgery. Here is the big gain for all parties concerned. Here the patient and hospital and insurance companies can all be big gainers. What is needed is the recognition that MIS procedures that can only be done with the DaVinci system should have a higher compensation level to the doctors and hospitals. This will [INVALID] the proper incentives for all those parties to use the DaVinci system more effectively. As doctors are becoming more proficient with the DaVinci system more and more complex procedures will be done with it. The result will be lower costs an better patient care.

bunny b (12/19/2012 at 11:22 AM)
I, for some reason, don't trust this robot only because i feel the hospital industry are rushing into using this robot meaning training time for the robot is way too short. I been reading other articles that claim surgeon training for these robots are only two days. Lives are not to be played with nor to be guinea pigs. I think training for the usage of the robot in operation should be an addition 2-4 years in school on top of the years surgeons go to school, because of the seriousness and mastering the use of the robot, reducing the risks of incidents and prove the seriousness of the use of the robot in real human operations.




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