Humans make better surgeons than robots, according to a study which suggests that machine-assisted surgery for kidney removal not only takes longer to perform, but also costs more. Researchers from Stanford University in the US looked at nearly 24,000 patients with kidney cancer.The analysis showed that the use of robot-assisted surgery to remove kidneys was not always more cost-effective than using traditional laparascopic methods.
However, the two approaches have comparable patient outcomes and lengths of hospital stay, researchers said. Laparoscopic surgery is a minimally invasive procedure in which surgical operations are done through small incisions. The removal of the entire kidney is called radical nephrectomy. “We found that, although there was no statistical difference in outcome or length of hospital stay, the robotic-assisted surgeries cost more and had a higher probability of prolonged operative time,” said Benjamin Chung, associate professor at Stanford.
Surgical robots are helpful because they offer more dexterity than traditional laparoscopic instrumentation and use a three-dimensional, high-resolution camera to visualise and magnify the operating field. While some procedures require a high degree of delicate manoeuvring and extensive internal suturing that render the robot’s assistance invaluable, researchers hypothesised that less technically challenging surgeries may not benefit as significantly from a robot’s help.
They analysed data from 416 hospitals from 2003 to 2015. Researchers found that among nearly 24,000 patients, almost 19,000 underwent a traditional laparoscopic procedure and about 5,000 underwent a robotic-assisted procedure. They found that 46.3 per cent of those patients whose surgeon used the robot had a total procedure time of more than four hours. In contrast, about 28.5 per cent of the patients whose surgeon used the conventional laparoscopic procedure were in the operating room for more than four hours.
On average, the total hospital cost for the robot-assisted procedure exceeded that of the traditional laparoscopic procedures by about $2,700 per patient. The researchers speculated that the increased cost may be due to longer times spent in the operating room and the disposable instruments upon which surgical robots rely. Researchers noted that the study covers a time period when many physicians were just learning to use the robots for this type of procedure.
It is possible that the operating time will decrease and that the cost differences between the two procedures will narrow over time. “But for now, the study suggests that robot-assisted surgery is not always the right choice,” researchers said.