Risks Involved with Robotic-Assisted Surgery Are Not to be Taken Lightly
The use of robotic assistance in surgery has expanded exponentially since it was first approved in 2000. Approximately 877,000 surgical procedures were performed with the da Vinci Surgical System in 2017. Many hospital's claim that robotic assisted surgery is a superior surgical method to open procedures, touting benefits such as shorter hospital stays, less pain, lower risk of infection, faster recovery times, and better clinical outcomes. What patients may not know, however, is that there is little evidence demonstrating that robotic-assisted surgery provides any long-term benefits over open techniques or a significant advantage over conventional laparoscopic surgery in a variety of procedures,. In fact, the American College of Obstetrics and Gynecologists acknowledges that of the several studies that compared robot-assisted surgery for benign gynecologic disease with laparoscopy, none showed any benefit from using the robotic approach. Additionally, many patients are unaware that robotic-assisted surgeries carry additional, unique risks.
In addition to the risks involved with any open or laparoscopic surgery, robotic-assisted surgery also includes the risk of mechanical failure. The robotic systems are made up of multiple components, including cameras, binocular lenses, robotic tower, robotic arms, and instruments, and each component has a risk of malfunction. Additionally, the robot's energy source is prone to electric arcing, which occurs when electrical current from the instrument leaves the robotic arm and is misdirected to surrounding tissue-this can cause internal burns, tissue damage, and quickly lead to life-threatening infection if not immediately recognized.
Robotic-assisted surgeries also carry the risk of human error. In these types of procedures, the surgeon is removed from the field of vision and is actually remote from the patient. This can make it more difficult to recognize tears in adjacent tissue, which can lead to serious complications, such as sepsis. Because the surgeon operates by remotely controlling robotic arms and instruments, he or she doesn't receive tactile feedback like a surgeon would when using his or her own hands. Unfamiliarity with the device can also lead to complications, as indicated by several studies showing that higher complication rates correlate to inexperience., While each procedure poses a different learning curve, the number of cases required to reach proficiency may be close to 100 cases.3 Do not be afraid to ask your surgeon about their experience with the device, the risks associated with the device and whether or not the device is any safer for you than conventional-open or laparoscopic surgery.
Ahmed F, Rhee J, Sutherland D, Benjamin C, Engel J, Frazier H II. Surgical complications after robot-assisted laparoscopic radical prostatectomy: the initial 1000 cases stratified by the Clavien classification system. J Endourol. 2012;26:135-139.