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.
Advocates of robotically assisted prostatectomy argue that the procedure brings a number of advantages. Among them: less blood loss, shorter stays in the hospital and faster recovery times. However, it isn't clear that the robotically assisted procedures provide an advantage when it comes to survival rates and urinary and erection problems. And it costs significantly more. Ashutosh Tewari, system chairman of the department of urology at Mount Sinai Health System in New York City, believes the robotic surgery is better.
Robot-assisted surgery to remove cancerous prostate glands is safe over the long term and has a major complication rate of less than 1 percent, according to research published by the journal European Urology. An earlier study showed almost 87 percent of patients had no recurrence of cancer after five years, according to a release by the Henry Ford Health System. The procedure removes the entire prostate gland and some surrounding tissue. Researchers followed 3,317 patients at the Vattikuti Urology Institute in Detroit from January 2005 to December 2009. The institute is known for the work of Dr. Mani Menon, who has been performing robot-assisted prostate removals since 2001.
A new trial in Australia is exploring how robots can improve the outcomes of prostate cancer surgery. On Friday, a new study was published in the academic journal Lancet which outlined a research project conducted by scientists at Griffith University, Queensland. See also: IBM calls healthcare industry a'leaky vessel in a stormy sea' The study focused on a new trial which compared patient outcomes and the success of prostatectomies, which are procedures designed to correct urinary and erectile dysfunction, as well as treat men diagnosed with prostate cancer. Prostate cancer is one of the most common forms of cancer diagnosed in men in the country. Approximately 18,300 men in Australia alone are diagnosed with prostate cancer every year.