Abstract
The interest that I have in robotic surgery stems from the discrepancies between literature at the time that my current hospital purchased their system and the aggressive marketing campaign from the parent company. In urology, the robot is marketed as “nerve-sparing” during prostatectomies and in cardiac it allowed more dexterity or finer motor control. The bulk of the concerns center around issues such as system resetting; electrosurgical arch; increased surgical time; prolonged carbon dioxide insufflation; unnecessarily extended amounts of time under anesthesia; and extremely high costs to purchase and maintain the system on site. A cost-based analysis and a surgical time consideration of robotic versus laparoscopic and open procedures disprove the regularly cited benefits of using a robotic console over the trained surgeon hands for not only surgical risk but financial benefits to both the facility and patient. I gathered records of robotic, laparoscopic and open procedures, the time each takes, the financials for instrumentation and the legal issues or complication associated for each. The robotic technique is a greater cost than any procedure comparable and at an increase of surgical and/or anesthetic time. The greater the anesthetic time, the more potential harm to patients. The greater the surgical time, the higher the risk from increased pneumoperitoneum CO2 insufflation on the cardiovascular and respiratory systems. The higher the cost ratio, the less benefit for the practicing facility. Legalities are a new issue to consider when the robot or the parent company is found at fault considering the health insurance agencies have taken a stand on compensation for only the diagnosis and not the techniques or technology utilized for that treatment.
Published Version
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