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JAMA Patient Page
September 11, 2013

Robotic Surgery

JAMA. 2013;310(10):1086. doi:10.1001/jama.2013.75621

Robotic surgery may sound a little too high-tech for comfort, but rest assured, the accurate term is robotic-assisted surgery.

A surgeon performs your procedure using very high-tech equipment. Originally designed for use on battlefields, today the “robot” has become the latest technology at hospitals worldwide.

Surgery Alternatives

There are 2 basic ways to do surgery. In open surgery, the surgeon makes a large incision to look and work directly inside the body. In laparoscopy (minimally invasive surgery), the surgeon makes 1 or more small incisions and inserts a light and a camera into the openings.

Many types of open surgical procedures can now be done laparoscopically. Advantages include smaller incisions, less blood loss (and less need for transfusions), less pain while recovering, and shorter hospital stays. Disadvantages include rigid tools, a need for the surgeon to operate tools in a tight space, and the surgeon’s view is on a video screen, which can be confusing.

What Is Robotic Surgery?

Robotic surgery is a newer kind of laparoscopic surgery. The surgeon makes small incisions, but the instruments work through a robotic device. The surgeon sits at a console and operates the robot’s arms, which in turn move tiny tools inside the patient’s body.

There are many advantages to robotic surgery. The surgeon can view a high-quality, 3-D image and can move his or her hands and wrists more naturally. The robot can reduce tremors in the surgeon’s movements and is helpful for surgery in tight spaces in the body. Robotic surgery is particularly helpful for certain types of procedures in which access is difficult.

Disadvantages include a significant learning curve for surgeons to become fully expert. Some surgeons miss the “feel” of direct contact with the patient’s organs. And robotic surgery takes longer, regardless of the surgeon’s expertise.

What Do the Studies Say?

There are few well-designed studies of robotic surgery compared with traditional laparoscopic surgery. A recent study found that there was no advantage to patients for robotic surgery, and it costs a great deal more than traditional laparoscopic surgery.

Cost

Robots can cost $1.5 million to $1.75 million each plus the expense of annual maintenance and the necessary disposable instruments. There is no manufacturing competition to lower costs; in the United States, only 1 system has FDA approval.

Without much better outcomes, it is difficult for hospitals to justify the purchase price. In the end, patients will pay for the overall increased costs in the form of higher insurance premiums.

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For More Information

To find this and previous JAMA Patient Pages, go to the Patient Page link on JAMA’s website at jama.com. Many are published in English and Spanish.

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Article Information
The JAMA Patient Page is a public service of JAMA. The information and recommendations appearing on this page are appropriate in most instances, but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA suggests that you consult your physician. This page may be photocopied noncommercially by physicians and other health care professionals to share with patients. To purchase bulk reprints, call 312/464-0776.

Conflict of Interest Disclosures: The author has completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.

Sources: National Library of Medicine. Wright J, et al. JAMA. 2013;309(7):689-698.

Topic: Surgery

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