NYT touts benefits of robotic surgery

With each development, surgery becomes less invasive

The New York Times explored the benefits of robotic surgery systems, which allow physicians to perform entire surgeries using a single, small incision and may speed patient recovery.

Currently, computer-operated robotic systems allow surgeons to perform procedures using small openings in the patient's body that are not larger than keyholes. However, these systems require multiple incisions, including at least one for the camera and several for the robotic arms that perform the procedure.

The new systems—one on the market and several others in development—require only one incision for both the camera and the robotic arms.

For example, Intuitive Surgical's Single-Site makes just one inch-long incision in the patient. The system—which has been approved for gallbladder removal by the FDA—is an add-on to Intuitive's da Vinci Si, a basic robotic system that costs between $1.3 million and $2.2 million. The Single-Site add-on costs about $60,000, depending on the hospital's existing equipment.

Meanwhile, Titan Medical is developing a robotic system that enters the body through an incision that is six-tenths of an inch long. Once in the body, the system unfolds and two "snakelike" arms perform the procedure, according to the Times.

Surgeons already could perform single incision surgeons using long, thin laparoscopic tools, but the procedures presented several challenges. For instance, the tools present ergonomic difficulties for doctors, and place pressure on the patient's tissue.

The robotic systems likely will address those challenges, according to Jeffrey J. Tomaszewski, a fellow at the Fox Chase Cancer Center in Philadelphia. "Robots are an extension and multiplier of our own surgical hands," he says.

However, it remains unclear whether the systems are cost-effective for hospitals. "We surgeons love using the robot," Tomaszewski says, adding, "But the question is, and what we all have to fight hard to do, is to determine for what procedure the robotic approach provides the best benefit" (Eisenberg, Times, 11/17).

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