Robotic Surgery Offers Patients "Tremendous Benefit”

Researchers at the Jewish General Hospital (JGH; Montreal, Canada) reported the results of prospective evaluation of perioperative data and a postoperative quality-of-life survey in their experience with robotic surgeries, concluding that even in the early phases of implementation of a robotic surgical program for endometrial cancer, the procedure seems safe and confers an excellent quality of life for elderly patients. As a result, surgeons at JGH went from performing minimally invasive surgery (MIS) via laparoscopy on only 15% of endometrial cancer patients to performing robotic surgery on 95% of the patients. Cervical cancer patients who did not enjoy MIS at all are now being treated by robotic surgery in all cases. The researchers also discovered that the rate of complications and outcomes between elderly and younger patients virtually disappeared when they underwent robotic surgery.

A cost analysis that compared open radical hysterectomy with a robotic radical hysterectomy calculated that the average cost of the traditional surgical method was CAD 11,764, including hospital accommodation, the fees for the surgeon and anesthetist, medications, and other expenses. By comparison, the robot-assisted procedure cost an average of CAD 9,613, including the amortization expense of the expensive equipment. The researchers calculated that if the robot were used on a high-volume basis, the average cost per surgery would drop to CAD 8,898. The series of studies were published between October 2010 and January 2011 in the Journal of Robotic Surgery and the International Journal of Gynecological Cancer.

"Robotic surgery definitely benefits patients and society,” said lead author Walter Gotlieb, MD, head of gynecologic oncology at the JGH Segal Cancer Center. "Patient quality of life is dramatically improved, their hospital stays are much shorter, and they use far less narcotic pain medication. The majority of our patients need nothing stronger than Tylenol.”

Robotic surgery is usually safer and cheaper than open surgery, as robotic hands are steadier than human hands, possess more freedom of movement (7 degrees) than a human arm (4 degrees), thus enabling the surgeon to operate with greater flexibility. The surgeon also has greater control during MIS involving laparoscopic insertions of fiberoptic camera scopes and surgical instruments.

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