Worth the cost? A closer look at the da Vinci robot's impact on prostate cancer surgery

Urology fellow, Jeremy Fallot, and nurse, Shauna Harnedy, assist in robotic surgery by Ruban Thanigasalam (out of view) in Sydney, Australia.Credit: Ken Leanfore for Nature Loved by surgeons and patients alike for its ease of use and faster recovery times, the da Vinci surgical robot is less invasive than conventional procedures, and lacks the awkwardness of laparoscopic (keyhole) surgery. But the robot's US$2-million price tag and negligible effect on cancer outcomes is sparking concern that it's crowding out more affordable treatments. There are more than 5,500 da Vinci robots globally, manufactured by California-based tech giant, Intuitive. The system is used in a range of surgical procedures, but its biggest impact has been in urology, where it has a market monopoly on robot-assisted radical prostatectomies (RARP), the removal of the prostate and surrounding tissues to treat localized cancer. Uptake in the United States, Europe, Australia, China and Japan for performing this procedure has been rapid.