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In Support Of Robotic Surgery

Mon, 08/15/2011 - 6:56am

PRNewswire - Robotics are helping surgeons make great strides in the medical arena, and the advanced technology used in robotic prostatectomy procedures delivers many benefits to both surgeon and patient. However, in recent news, there is some scrutiny on the frequency of its use. Further, some critics are cautioning patients against the mass marketing of robotic surgery and its benefits. Dr. David Samadi, Vice Chairman, Department of Urology, and Chief of Robotics and Minimally Invasive Surgery at The Mount Sinai Medical Center in New York City, agrees that in some cases the technology is being oversold, but still firmly believes in the benefits of robotic surgery.

While dedicated to the care and treatment of patients, hospitals are still businesses that compete with one another. The latest technology, more skilled surgeons and better facilities are all part of their marketing arsenal. A recent report in the Journal for Healthcare Quality primarily criticized hospitals for making too much of robotic surgery on their websites. The study, designed to highlight the over-marketing of robotic surgery, accused hospitals of relying too heavily on the positive outcome statistics without disclosing the potential risks of robotic surgery.

"Surgical procedures do present some risk," reminds Dr. Samadi. "It's important for patients to thoroughly research the procedure, the surgeon and the hospital before making any decisions. There's so much information out there that it can be difficult to sift through it all. You must choose a surgeon you feel comfortable with."

Robotic surgery is also disparaged for its expense. Last month The Medical College of Wisconsin published information showing that in-state hospitals with newly obtained robotic equipment saw their number of prostatectomy procedures double over a three-month period, while the incidence remained the same in those without the technology. Some believe that surgeons and hospitals offering robotic procedures must work to make-up the expense of the equipment; that the hospitals may be pressuring them to cover procurement and maintenance costs.

There are, however, numerous publications documenting the cost-saving benefits of robotic surgery. For many patients, robotic surgery reduces hospital stay, blood loss and post-operative complications, all of which can help a patient return to their normal schedules more quickly.

Dr. Samadi, who has been performing robotic prostatectomy procedures for ten years, is sensitive to the concerns about the technology. "The equipment is costly, but in the hands of the right surgeon it can save lives." Dr. Samadi also reminds patients that technology alone is not the key to success. Choosing a surgeon with a solid foundation in open and laparoscopic surgery, as well as extensive robotic surgery experience, is a must.

Beyond the technology, the frequency of prostatectomy procedures is often debated by "watchful waiting" supporters. Some specialists recommend that patients diagnosed with early prostate cancer postpone surgery or other treatment modalities, opting instead to keep an eye on its development before aggressively treating the cancer. Dr. Samadi believes that for most patients the best course of action is to remove the prostate gland, and a new study in The New England Journal of Medicine supports Dr. Samadi's beliefs.

Following 700 prostate cancer patients over a 15-year period – half opting for watchful waiting, half for prostate removal – the NEJM found that surgical removal of the prostate provides a 38 percent decrease in the risk of death from prostate cancer. "The survival benefits are great," asserts Dr. Samadi. However, he does acknowledge that for a small percentage of patients, the cancer may return after radical prostatectomy procedures. "In those cases radiation can be used but only after surgery. If a patient opts to have radiation before prostate gland removal, the chances of being able to perform the surgery later are very slim."

Dr. Samadi has performed over 3,500 successful robotic prostatectomy procedures and has a prostate cancer cure rate of 97 percent. For the more than 200,000 men diagnosed with prostate cancer each year, Dr. Samadi believes robotic prostatectomy is a very viable choice. "The message is not to operate on everyone, but the cancer doesn't belong there. Remove the cancer completely and know where you stand."

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