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Robots, Weight Loss Surgery, and a Twisted Tale Out of Baltimore

Cheryl Clark, for HealthLeaders Media, February 21, 2013

Everything you know is wrong.

That phrase comes to mind after a cluster of surprises from news and research papers this week threw conventional practice wisdom onto the bird cage floor like yesterday's news.

First, there was the report showing that a common surgery for benign gynecologic disease such as fibroids produced no better patient quality outcomes when surgeons performed it using the expensive, and heavily marketed, da Vinci robot than when they operated with traditional laparoscopic techniques.

Only the price tag differed, with da Vinci procedures costing on average of $2,189 more. Yet the da Vinci performed 138,000, or 37%, of the total number of 376,000 procedures done by the robot in U.S. hospitals last year, according to the robot's manufacturer, Intuitive Surgical Inc.

The study, published in the Journal of the American Medical Association by Jason Wright, MD, of Columbia University,prompted a comment from Frank Loffer, MD, medical director of the American Association of Gynecologic Laparoscopists, which has recently raised questions about the robot's popularity despite a lack of evidence that it's a better choice for women undergoing a hysterectomy.

"Mainly this is marketing on the part of hospitals and physicians, persuading patients to come in fixed on the idea, saying 'I want the latest; I want a robotic procedure, and if you don't do it I'm going to go to the guy next door.'  Robotics is the latest and robotics is sexy," says Loffer, a gynecologic surgeon at the University of Arizona.

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1 comments on "Robots, Weight Loss Surgery, and a Twisted Tale Out of Baltimore"


WS (2/27/2013 at 12:31 PM)
Over-treatment and unnecessary treatment are making us sicker and poorer. The medical surgical industrial complex is too driven by the "almighty dollar." We need to return to conservative treatments and stop messing with "mother nature." This will likely require a complete overhaul of the "fee for service" payment structure. Take women's health, for example. The two most overused surgeries are c-section and hysterectomy. As part of the Choosing Wisely Campaign to reduce unnecessary tests and procedures, ACOG included c-section on their list. Why is hysterectomy not on this list? This is especially suspect since a study concluded that 76% of hysterectomies don't meet ACOG's criteria for the surgery. And healthy ovaries are removed in about 73% of hysterectomies so oophorectomy is another surgery that's WAY overused. Women's organs are being removed at alarming rates - 600,000+ hysterectomies every year with 1 in 2 women having one by age 72. Just as a man's SEX organs are needed for optimal health his entire life, so are a woman's.