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Surgery Overkill: Why Do We Love Robotic Procedures?


The treatments cost more and, at least in the case of prostate surgeries and hysterectomies, there's no evidence they do a better job, yet as National Public Radio put it, "it's hard to resist a robot." Especially for older men.

Even though most medical associations have warned men with early stage prostate cancer not to rush into unneeded treatment - like surgery or radiation that could leave them incontinent or impotent  - older men are increasingly choosing expensive new treatments, including robotic surgery, despite that these procedures probably won't help them.

A study published Wednesday in JAMA, the Journal of the American Medical Association, found that use of these newer treatments rose from 32 to 44 percent between 2004 and 2009 among more than 83,000 men 66 or older with low prostate-screening test scores or other indications that their prostate cancer was slow growing and didn't pose a threat, NPR reported.

More troubling is that among the men in the study who already were in poor health for other reasons and therefore more likely to die from something other than prostate cancer, use of robotic surgery and a radiation treatment called intensity-modulated radiation therapy, or IMRT, nearly doubled, from 13 to 24 percent.

According to the researchers, men older than 65 with low-grade prostate cancer have about a 25 percent chance of dying from it 20 years after diagnosis - but a more than 60 percent chance of dying of other causes.

Robotic surgery is heavily promoted by doctors and hospitals as advanced technology that offers fewer side effects and faster recovery, but the study notes that "comparative studies have shown that the advantages of these newer treatments are marginal at best."

See also: New Website to Post Payments to Doctors From Health Industry

Robotic surgery has also been questioned for hysterectomies. A study published in JAMA earlier this year by researchers at Columbia University found that using a robot added about $2,000 to the procedure without providing women with any greater benefit than having a minimally invasive laparoscopic hysterectomy.

An editorial accompanying the hysterectomy study cautioned hospitals about promoting expensive robotic surgery without more evidence that it improves outcomes, the Wall Street Journal reported.

But big hospitals find it hard to turn down new technology, especially when patients are demanding it.

Michael Zinner, M.D., head of surgery at Brigham and Women's Hospital in Boston and coauthor of the JAMA editorial, admitted to the Wall Street Journal that the two robots at his hospital are in such constant use, the facility is acquiring a third.

Photo: wikimedia commons


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