When something goes wrong after robotic surgery with the da Vinci surgical system, it's most likely due to co-morbidities in certain patients that make the procedure riskier, not flaws in the robot's technology itself, according to a study of 884 surgeries published this week in the Archives of Surgery.
"After reviewing all these cases, we can say for sure that there is no specific morbidity connected with the robot by itself, and that its mechanical failure is very, very rare," says lead author Pier C. Giulianotti, MD, of the Division of General and Minimally Invasive Surgery at the University of Illinois at Chicago. "We can now say that the morbidity and mortality that occurred in these patients was connected to the risk factors in the patients."
The authors wrote that by understanding which patients are at greater risk for robotic surgery complications, surgeons eventually can develop a scoring system to measure quality of care among providers and hospitals.
The authors determined that among these 884 robotic surgeries, the need to resort to non-robotic surgery techniques because of unanticipated complications was 2%; the re-operation rate was 2.4%; the mortality rate was .5%; the overall postoperative was 16.7%; and the mean length of stay was 4.5 days. Giulianotti says that all the 884 procedures were done with the da Vinci system, and were assessed for complications that occurred within 30 days of hospital discharge.
Giulianotti emphasized that robotic surgery is, across the board, "clearly superior" than procedures done with open incisions or laparoscopy. "You don't leave big scars and adhesions, you have less post-operative pain, recovery times are shorter, and infection rates almost non-existent."