What's Wrong with the da Vinci Robot?

Joe Cantlupe, for HealthLeaders Media , January 26, 2012

Leonardo da Vinci was a study in contradictions: He was an artist and a scientist who often didn't finish what he started. He despised war but invented deadly weapons.  As the painter of the Mona Lisa, he was highly praised, but only completed a few other artistic works.  He studied elements of flying, but never published his ideas.

Da Vinci's inconsistencies made me think of the da Vinci Robot, his namesake device that some see as revolutionizing healthcare and others see as revolting: Indeed, it is a study in conflict itself.

Surgeons control the da Vinci from a console designed for minimally invasive techniques.

The robot was once again in the news recently in the wake of a report from the ECRI Institute that identified the da Vinci robot, as well as some other technologies, that fail to improve care—or were weak—based on data the institute collected. The ECRI Institute, based in Plymouth Meeting, PA, researches cost-effectiveness in patient care.

ECRI acknowledges that, as more physician residents are trained in the da Vinci robot, there is growing pressure among hospitals to acquire it, which costs between $1 million to $3 million apiece. What's more, applications for robot-assisted surgery have "outpaced supporting clinical evidence for improved patient outcomes, cost-effectiveness and commensurate reimbursement," ECRI states.

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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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