The slick marketing for the da Vinci robot trumpets that the "future of surgery is here." A recent radio ad in Buffalo even went so far as to suggest the device might be miraculous, a level of hype not usually seen in healthcare. To be sure, Intuitive Surgical's hugely successful -- and costly -- system for robot-assisted surgery looks futuristic. A physician sits at a console, staring into a 3-D monitor with magnification while manipulating hand and foot controllers that operate tiny instruments attached to robotic arms situated over the patient and inserted into the body through a few small incisions. But the competitive rush to buy robots -- there are five in Buffalo -- has placed the devices at the center of a debate over the adoption of new, costly technology before it's known if the advance is better than existing approaches or if the benefits outweigh the expenses. The da Vinci can cost as much as $2.5 million and requires annual maintenance contracts of $100,000 to $130,000, as well as about $2,000 for single-use tools in every procedure.