Robot use in surgery debated
For all the millions UPMC spends on marketing, you won't see a single ad promoting robotic surgery. Not on TV, not in newspapers and not on its purple-hued website. Officials promoting the region's health giant skillfully avoid trumpeting its use of a popular but controversial procedure.
You can't blame them. The Food and Drug Administration this year opened an inquiry into the safety of the da Vinci Surgical System, perhaps one of the most talked about technological advancements in medicine. Surgeons use the da Vinci robots to do hysterectomies, gastric bypasses and even kidney transplants. Last year, robots assisted in more than 400,000 surgeries nationwide.
UPMC owns eight robots, which come with the promise of smaller incisions and quicker recovery time. The machines cost more than $2 million each and California manufacturer Intuitive Surgical Inc. is raking in about $610 million in sales.
Product liability lawsuits filed against the company allege that surgeons aren't properly trained and the robots have defects that cause surgical complications. The FDA is reviewing circumstances of five deaths tied to the robots and several incidents in which patients sustained complications. None of those incidents is local.
One of the robots' most prolific users is Dr. Jeff Cohen, a urologist at Allegheny General Hospital in the North Side, which has one robot (West Penn Allegheny Health System has two others, at West Penn and Forbes Regional hospitals).
Cohen said he initially was skeptical of the robot, which he began using about six years ago to remove prostates. He's certain that problems with robotic surgery arise when surgeons aren't properly trained.
“Have you ever heard a doctor say ‘I'm really bad at something?' ” Cohen asked me. In other words, some surgeons aren't willing to admit they're not good at using the robot.
When Cohen started using the robot, by manipulating its arms through a console of hand controls and foot pedals, it took him six hours to finish one surgery. He now can do that in about 90 minutes.
Cohen estimates he and his partners have performed more than 500 surgeries using robots. The upshot? Less blood loss, less time in the hospital and less recovery time.
Dr. Joel Nelson, chair of urology at UPMC, said there's no significant difference in outcomes when you compare robotic surgery for prostate cancer to the standard open procedure.
He led a study published last year that showed the robot-assisted surgery is significantly more expensive than the traditional surgery to remove the prostate. The study found that UPMC Shadyside lost $4,013, on average, on each robotic-assisted prostate surgery.
Nelson doesn't do robotic-assisted surgery, but his colleagues do. He conceded that about the only benefit of using the robot is having a “more cosmetically pleasing result” with smaller incisions.
“You have to ask yourself, what price are you willing to pay to get that?” Nelson said. “It's a personal choice.”
Indeed, a personal choice that comes at a price. Though robots might have a place in medicine, they never will replace humans. It's up to humans to make sure robots do what they're expected to do — without taking over medicine.
Luis Fábregas is a Trib Total Media staff writer. Reach him at 412-320-7998 or firstname.lastname@example.org.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Officials identify man, woman killed in apparent Oakland murder-suicide
- LaBar: WWE not backing down from controversy
- Stat dropoff, road struggles have Penguins seeking consistency
- Rossi: In Super city, everything but football matters
- Beloved North Side gardener gets new truck, paid for by her neighbors
- LCB, Duquesne University police recover rare bourbon in illegal sale
- Overnight snow delaying schools in western Pennsylvania
- Driver leaps from sliding truck just before it topples down hillside in Fawn
- Hotel Monaco creative director: Whimsical decor requires open mind
- Pa. Treasurer McCord resigns without explanation, to leave Feb. 12
- Kennametal plans plant closings, job cuts in fallout from oil and gas decline