Making the Most of Robotic-Assisted Surgery
Making the Most of Robotic-Assisted Surgery
Editor's Note: The use of robotic-assisted laparoscopic surgery has grown in the past decade, especially in the field of urologic surgery, as retrospective studies and small case series have suggested that it can reduce mortality, length of hospital stay, and blood loss compared with open surgery. However, robotic-assisted procedures are more expensive; benefits have not been seen uniformly across all types of surgery; and robust, prospective evidence demonstrating clinical benefit is lacking.
In an interview with Medscape, J. Kellogg Parsons, MD, MHS, Associate Professor of Urology at the University of California, San Diego, Moores Cancer Center, reviewed what we know about the use of robotic-assisted surgery and considered how it might best be used to enhance surgeons' abilities and improve patient outcomes.
Medscape: Studies conducted by your group and others have looked at outcomes in patients undergoing robotic-assisted laparoscopic vs "pure" laparoscopic vs open procedures, and specifically at differences in terms of length of stay in the hospital, complication rates, and cost-effectiveness. What have we learned from comparisons among these different techniques?
Dr. Parsons: There are 2 guiding principles that we need to keep in mind. The first is that the robot is simply a tool, and the single most important factor in achieving success for any operation is the surgeon who is wielding the tool. The second thing to keep in mind is that, in weighing the potential advantages of robotic-assisted surgery, you have to consider the type of surgery in which it is being applied because the robotic assistance might not fit well with all procedures.
Editor's Note: The use of robotic-assisted laparoscopic surgery has grown in the past decade, especially in the field of urologic surgery, as retrospective studies and small case series have suggested that it can reduce mortality, length of hospital stay, and blood loss compared with open surgery. However, robotic-assisted procedures are more expensive; benefits have not been seen uniformly across all types of surgery; and robust, prospective evidence demonstrating clinical benefit is lacking.
In an interview with Medscape, J. Kellogg Parsons, MD, MHS, Associate Professor of Urology at the University of California, San Diego, Moores Cancer Center, reviewed what we know about the use of robotic-assisted surgery and considered how it might best be used to enhance surgeons' abilities and improve patient outcomes.
Medscape: Studies conducted by your group and others have looked at outcomes in patients undergoing robotic-assisted laparoscopic vs "pure" laparoscopic vs open procedures, and specifically at differences in terms of length of stay in the hospital, complication rates, and cost-effectiveness. What have we learned from comparisons among these different techniques?
Dr. Parsons: There are 2 guiding principles that we need to keep in mind. The first is that the robot is simply a tool, and the single most important factor in achieving success for any operation is the surgeon who is wielding the tool. The second thing to keep in mind is that, in weighing the potential advantages of robotic-assisted surgery, you have to consider the type of surgery in which it is being applied because the robotic assistance might not fit well with all procedures.
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