Robots That Kill

I've been writing about healthcare technology for a while and one of the areas I've focused on is how robotic surgery is changing the face of medicine.  Well, maybe not so much.

The big pluses were supposed to be that it was non-invasive, required only a single incision, people healed faster, there was less blood loss, and its outcomes were supposed to justify the cost (sometimes twice "open surgery").

Only, a major study just recently found that outcomes are no better with this type of surgery, and can sometimes even kill you, according to a story in today's NYT by Roni Caryn Rabin.

This kind of surgery is typically used for prostatectomies and hysterectomies (my own OB-GYN performs them this way).  How it works is that the surgeon sits at a console  in the operating room connected to a camera that provides a high-definition picture of the surgical site, then moves the robotic arms to mimic what his own hands would be doing, based on the camera image.

Sounds great, but the only problem is, as in the case of a 67-year-old retiree who was having his prostate removed, things went terribly wrong, and Rabin writes, became "incontinent," and needed a colostomy bag, and the surgery led to "kidney and lung damage, sepsis and a stroke."

He died not too many years later, after having his quality of life completely destroyed.

His wife is now suing the surgeon, who, it turns out, had very little training on this equipment (named, for some reason, after Leonardo daVinci), and whose hospital was conned into buying it by high-pressure sales reps.

The company involved in this, Intuitive Surgical, based on the West Coast, had initially promised to do lots of training with doctors before they used the system, then skinned the training down from a 70-question exam to a 10-question online quiz, Rabin reports, also going from three days of training down to one, because doctors protested it all took too long.

Who knows if this is the reason why the retiree's surgery was bungled?  No one, it seems, but having been a patient waiting over an hour to see a doctor several times while he entertained drug sales reps (and accepted their free samples and coffee cake and maybe even promises of all expenses-paid vacations), I understand the persistence -- and often, success -- of these sales geniuses.  Usually not to the benefit of the patient.

I know. It's a dog-eat-dog world and you have to make a living. But a process that allows salespeople into surgical suites, sometimes even performing the surgery, is a little too scary for me.

Of course I believe in technology and the many advances it's brought to our lives in this arena.  But maybe medicine is moving too fast to keep up, to keep competitive, to keep making money any way, anyhow.




http://robotics.tmcnet.com//channels/healthcare-robotics/articles/259286-new-robotic-assisted-magellan-allows-uk-surgeons-operate.htm

http://www.nytimes.com/2013/03/26/health/salesmen-in-the-surgical-suite.html?pagewanted=all&_r=0&gwh=6F3C6C810F4A4B1BD48D818B76C3478D

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