23 July 2012

Hospitals hype robot surgery for women: study

Consumers shouldn't expect straight talk about robot surgery from hospital websites, but rather vague claims and marketing mantras, according to a new US study.

Consumers shouldn't expect straight talk about robot surgery from hospital websites, but rather vague claims and marketing mantras, according to a new US study. Researchers sifted through online information from 432 hospitals across the country and found nearly half marketed robotic surgery for gynaecologic conditions such as endometriosis or cervical cancer.

A quarter of those hospitals used boilerplate copy from the robot manufacturer Intuitive Surgical, and one in six told consumers, "You owe it to yourself". However, almost none mentioned potential downsides to the technology such as increased operating time or higher cost compared with conventional types of surgery.

"This is marketing," said Dr Jason Wright, a gynaecologic surgeon at Columbia University in New York, who led the new work. "Many of the claims that were made by hospitals were not supported by high-quality data."Robot surgery originally took off as a new way to operate on men with prostate cancer, but doctors have since started using it for several other procedures, too. Today, the technology is being used in hundreds of thousands of surgeries every year.

According to California-based Intuitive Surgical, more than 2 200 of its Da Vinci robots have been installed worldwide. The machines run between $1 million and $2.5 million (R17 mill) each. Compared with open surgery, robot-assisted surgery leads to a faster recovery and less blood loss, said Dr Wright. But it's not clear that it has any advantages over laparoscopic procedures, he added.

Role for robotic surgery

"There is definitely a role for robotic surgery and I think it is an exciting technology," said Dr Wright, who uses the technology himself. "But right now the data are really very limited."Dr Wright's team found that most hospitals described robot surgery as having several benefits, but just 15% referenced data from clinical trials to support those claims.

And only a few hospitals discussed the risks, operating time and price, which is usually at least $1 000(R8 400) higher than for traditional laparoscopy. The paper, published online in the American Journal of Obstetrics & Gynecology, agrees with a report from last year that looked at how US hospitals describe robot surgery in general on their websites.

That study, in the Journal for Healthcare Quality, concluded that online materials "overestimate benefits, largely ignore risks and are strongly influenced by the manufacturer."In a quick Web search, Reuters Health found several hospitals advertising "better clinical outcomes" with robot surgery. Yet none of them made clear what those outcomes were or what treatment the comparison group got.

Video touting of robotic surgery

The Nebraska Medical Center in Omaha is a case in point. From its homepage, it takes just two clicks to get to a video touting robotic surgery for gynaecologic cancer."This is all brand new, it's phenomenal, it's changed how we practise medicine," Dr Kerry Rodabaugh exclaims as the video begins.

Four minutes later, without having mentioned any risks, she ends the piece by saying, "It's really wonderful to be able to give this option to patients, because it's just plain better." Dr Rodabaugh did not return phone calls requesting comments; nor did the marketing directors of two other hospitals, St. Anthony's Medical Center in St. Louis and the University of Missouri Health Care in Columbia, both of which advertise robot surgery on their websites.

Dr Wright acknowledged that many hospitals are businesses and have the right to market their services. But at the same time, patients trust hospitals to provide more balanced information than manufacturers, he said."Most patients have a higher expectation of physicians and hospitals," Dr Wright told Reuters Health. "Hospitals should have a mandate to supply unbiased information to patients."

(Reuters Health, Frederik Joelving, July 2012)

Read more: 

Robotic surgeries costlier but safer


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