Robotic Surgery: Separating Reality from Hype

Hysterectomy performed with robotic surgery garners ACOG statement

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Robotic surgery sounds so high tech. But are these surgeries better than conventional methods? What should a woman know about robotic surgery if she's having a hysterectomy?

Hysterectomies are the surgical removal of the uterus or womb. Other organs, including the ovaries, may be removed at the same time.

These surgeries are performed for a number of reasons, including to treat cervical, uterine, endometrial (lining of the uterus) or ovarian cancer.

The President of the American Congress of Obstetricians and Gynecologists (ACOG), James T. Breeden, MD, has issued a statement regarding the use of robotic surgery for hysterectomies.

Dr. Breeden asks women to get the facts and to separate the reality from the marketing hype when considering robotic surgery for their hysterectomy.

"Talk to a doctor about all of your surgery options."

Dr. Breeden said in the statement, "Robotic surgery is not the only or the best minimally invasive approach for hysterectomy. Nor is it the most cost efficient. It is important to separate the marketing hype from the reality when considering the best surgical approach for hysterectomies."

The surgeon's skill is the most important determining factor of the outcome of any surgery. Dr. Breeden points out that the training time for robotic surgery – which is performed by robotic arms the surgeon controls from a console, much like a video game – and expertise varies widely among surgeons and hospitals.

"While there may be some advantages to the use of robotics in complex hysterectomies, especially for cancer operations that require extensive surgery and removal of lymph nodes, studies have shown that adding this expensive technology for routine surgical care does not improve patient outcomes. Consequently, there is no good data proving that robotic hysterectomy is even as good as—let alone better—than existing, and far less costly, minimally invasive alternatives," Dr. Breeden said in the statement.

Dr. Breeden summarized a woman's options.

  • Vaginal hysterectomy is performed through a small opening at the top of the vagina with no abdominal incisions. This is the least invasive and least expensive surgical option.
  • Laparascopic hysterectomy is performed with a thin tube that's inserted into the navel through very small incisions. This is the second least invasive and expensive option.
  • Robotic surgery adds about $2,000 to the cost of the operation. It generally offers shorter hospitalization, less discomfort and faster recovery compared to the traditional total abdominal hysterectomy that requires a large incision.

"Patients should be advised that robotic hysterectomy is best used for unusual and complex clinical conditions in which improved outcomes over standard minimally invasive approaches have been demonstrated," Dr. Breeden said.

He added that in a time when the country is looking a fiscal responsibility and transparency in terms of healthcare costs, "Our patients deserve and need factual information about all of their treatment options, including costs, so that they can make truly informed healthcare decisions."

This statement was issued March 14 and appears on the ACOG website.

Reviewed by: 
Review Date: 
March 15, 2013
Last Updated:
March 17, 2013