Robotic surgeries costlier but safer

Patients who have robot-assisted surgeries on their kidneys or prostate have shorter hospital stays and a lower risk of having a blood transfusion or dying — but the bill is significantly higher, a study found. The analysis, which appeared in the Journal of Urology, compared increasingly common robotic surgery with two other techniques for the same surgery and found that direct costs can be up to several thousand dollars higher for the robotic type. Touted as less invasive and more efficient, robotic surgeries typically use a laparoscopic or "keyhold surgery" approach, in which tools and a tiny video camera are inserted into the body through one or two small incisions. Robotic surgery replaces a surgeon's hands with ultra-precise tools at the ends of mechanical arms, all operated by the surgeon from a console. "I think the take home message is that robotic surgery, looking at our study, had certain beneficial outcomes compared to open and laparoscopic procedures," said study leader Jim Hu at Brigham and Women's Hospital in Boston. Hu and his team analysed surgery data from a national government database to see if the costlier robotic surgeries were cost effective with extra benefits over older techniques. During the last three months of 2008 — the most recent data available that allowed a comparison among robotic, open and laparoscopic surgeries — more than half of all prostate removals involved robot-assisted surgery. About three per cent of prostate patients had standard laparoscopic surgery and 44 per cent had open surgery. Open and laparoscopic surgeries were still more common than robotic surgeries for kidney repairs and removals. Among patients who had their prostate removed, none died from laparoscopic or robotic surgery, whereas two out of every 1,000 died after the open procedure