Wright says that though laparoscopic surgery has been around since the 1990s, "the uptake has been relatively slow." But once the da Vinci robot was introduced in 2005, the percentage of women who underwent abdominal hysterectomy began to drop. For some reason, the number of surgeons willing to perform the procedure less-expensively, with traditional laparoscopic techniques, never really took off.
Wright says that because of the number of patients in his analysis, his report might change the conversation between gynecologic surgeons and their patients. "It's reassuring because for both procedures, for lap and robotic hysterectomy, the complication rate was low for both operations."
Intuitive says some 1,871 da Vinci robots are now in use in U.S. hospitals, where they are approved by the U.S. Food and Drug Administration for otolaryngologic and thoracoscopic procedures in addition to gynecologic and urologic surgery. The robots are also used for cholecystectomy, gastric bypass, and mitral valve repair. Prices ranges from $1.2 million to $2.2 million per machine.
An accompanying editorial by Joel Weissman, PhD and Michael Zinner, MD, of Brigham and Women's Hospital in Boston, said hospitals and doctors need to keep better registry data, because robotic surgery may prove more "valuable for subgroups of patients with select comorbidities or anatomy."
Nevertheless, they criticize the "commercialization of this technology, which has raised eyebrows in the media and elsewhere" for taking direct-to-consumer marketing "to a higher level with advanced campaigns not only by industry but also by surgeons and the hospitals that own the machines."
When what is being advertised "is of questionable advantage, direct-to-consumer promotion may only fuel unnecessary utilization," they wrote. "Consumer advertising of expensive devices should be subjected to the same scrutiny as that of new and expensive medications."