by
Olga Deshchenko, DOTmed News Reporter | July 01, 2010
"A lot of people showed enthusiasm for the robotic initiative, but right now there's kind of a backlash," says Dr. Nguyen. "People are saying it's too expensive and no better than open surgery."
Critics say that hospitals are marketing and advertising robotic procedures without much comprehensive clinical data to support the claim that it is, in fact, better than other treatment options. In 2009, the Institute for Clinical and Economic Review (ICER), an academic comparative research and policy program based at the Institute of Technology Assessment at Massachusetts General Hospital, released a report comparing the different approaches to managing prostate cancer. It found that, "rates of survival and tumor recurrence are similar among the most common treatment approaches, although costs can vary considerably."
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Dr. Hiep Nguyen
of the Center
for Robotic Surgery
at Children's Hospital
Boston
In another study published in the May issue of the Journal of Urology, researchers did a prospective analysis and looked at the baseline function and bother scores of 785 patients who underwent treatment for localized prostate cancer between 2000 and 2008. The study considered four different options: open or robotic prostatectomy, cryoblation and brachytherapy.
The researchers attempted to determine if robotic surgery made a major difference in the patients' quality of life, to find out if it justified the higher cost involved. Dr. Michael Fabrizio, division chief of urology at the Sentara Medical Group in Virginia and an associate professor of urology at the Eastern Virginia Medical School, is one of the study's authors.
"Quite to our surprise, there's not a significant difference between the open and robotic approaches with respect to urinary function, sexual function or bowel function or bother," says Dr. Fabrizio. "But there was a dramatic difference in recovery when you look at brachytherapy and cryoblation with respect to urinary function and with sexual function in respect to brachytherapy. There was a threefold greater chance that you would return to baseline function if you had brachytherapy at the end of a two-year interval as opposed to if you had surgery," he says.
