MD4Bernie

MD4Bernie t1_ir2ylrh wrote

Sorry, your notion that the robotic prostatectomy is better than a regular prostatectomy is about 15 years out-of-date.

Yes, they tried to make "function-sparing prostatectomy" the killer app for the insanely expensive operating robot. (And to be clear, the "function" we are talking about is potency, the man's ability to maintain an erection after surgery.) Maintaining potency is, of course, and admirable goal.

Problem is that maintaining potency also ended up maintaining the cancer cells. Yes, a higher percentage of "targeted resection" patients maintained their potency; but they also still had cancer.

The da Vinci is a dangerous, expensive cure in search of a disease. It makes bad surgeons even worse. Excellent surgeons rarely (if ever) need a gee-whiz marketing angle to prove to patients that they are up-to-date on all the expensive gizmos.

−5

MD4Bernie t1_iqtiwk9 wrote

Literally millions of dollars underwriting study after study, and the most they can show is that--in experienced hands, defined as surgeons who have done over 100 of the procedures in question--the robot is as good as (cheaper) regular laparoscopy (the operating cameras that have been the standard of care since the late 1900s). The "difference" robotic shills like to tout are exclusively in comparison to open procedures, which aren't really done anymore (because laparoscopy was such a huge advance).

The Da Vinci is a hugely expensive, dangerous cure in search of a disease. First, the disease was prostate cancer. When robotic surgeons couldn't do as well as run-of-the-mill urologists, Intuitive went after Gyn-Onc. And then bariatrics. Last I heard they were thinking routine gallbladders might make their ridiculously expensive investments pay off.

My advice, as a physician whose solitary job is to protect patients from surgeons, is to find the surgeon who has done the very most laparoscopic versions of whatever surgery you require, and ask him or her to operate on you.

Sure, if you are charitable and want to donate your body to science fiction, let a surgeon perform a robotic surgery on you, knowing that in a few decades your sacrifice might be part of the reason the operating robot can ... umm, I confess I don't even know that the grand robotic vision is. But you can be among the volunteers that suffered for its cause.

1