|March 2013 · Vol. 25, No. 3
Robotic surgery not the best for hysterectomy, ACOG says
ACOG’s president James T. Breeden, MD, says direct-to-consumer marketing may lead women to believe robotics is best choice
Robotic surgery is not the only, the best, or the most cost-efficient method for a minimally invasive hysterectomy, according to a statement published by the American College of Obstetricians & Gynecologists (ACOG).
James T. Breeden, M.D., ACOG’s president, released a statement to counter some of the aggressive, direct-to-consumer marketing pushing robotic surgery, saying that patients need factual information about all treatment options, including vaginal and laparoscopic hysterectomies.
ACOG says that expertise with robotic hysterectomies is still limited and, during the learning curve associated with new surgical methodologies, there can be increased complications. Adding the expensive technology for routine surgical care does not improve outcomes, studies have found. Evidence shows that vaginal hysterectomies are the least invasive and least expensive option, with laparoscopic hysterectomies coming in second on both measures. Hospitalizations and recovery times are shorter with both vaginal and laparoscopic hysterectomies, compared with traditional total abdominal hysterectomies. Robotic surgery is the most expensive option, adding an average of $2,000 per procedure without any clinical benefit, according to a recent study. Despite the expense, in 3 years, the percentage of hysterectomies performed robotically has increased from 0.5% to 10%. If robotic surgery were used for all hysterectomies, roughly one billion dollars of costs would be added to the health-care system.
“While there may be some advantages to the use of robotics in complex hysterectomies, especially for cancer operations that require extensive surgery and removal of lymph nodes, studies have shown that adding this expensive technology for routine surgical care does not improve patient outcomes,” Breeden said in a statement.
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