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| Archive : Winter 2007 |
PAGING DR. DA VINCI:
Scissors? Check. // Forceps? Check. // Cameras? Check. // The newest doctor can remove prostates, repair heart valves and reattach tissues. And it’s not even human.
Meet:
The Robot Surgeon [page 4]
 By Charles Slack // Additional reporting by Andrea Appleton |
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A few miles away, at the MGH, president Peter Slavin has yet to be convinced that the hospital needs a da Vinci at all. “Perhaps the most important benefit, from my perspective, is that the robot is innovative,” Slavin says. “Hospitals, particularly teaching hospitals, have a responsibility to promote innovation. But we can’t do that in every case. We have to be somewhat selective. And so far we haven’t been convinced that this is an opportunity of sufficient value.”
Still, Slavin calls the da Vinci “one of the most interesting case studies of technology adoption I’ve ever encountered. As administrators, we face major decisions every day—about which personnel to hire, and what equipment, drugs and devices to purchase. This is a dramatic example of those decisions.”
A major test of the da Vinci’s value—and that of future robotic devices—will be randomized, controlled tests that can determine how well patients do years after a procedure. If the results can’t match those of open surgery, Cohn says, faster and less painful surgery won’t hold much value. “It’s great to have new technology, but at the end of the day, you’d better have at least as good a result as you did with the old technique, or you’re just kidding yourself.”
 Dossier
1. “Robotics in Urologic Surgery: An Evolving New Technology,” by Fatih Atug et al., International Journal of Urology, June 2006. A comprehensive discussion of the development of robotic surgery.
2. “Endoscopic robotic mitral valve surgery,” by Douglas A. Murphy
et al., Journal of Thoracic and Cardiovascular Surgery, October 2006. A study that finds robot-assisted surgery to be “safe and effective” for 127 heart patients needing mitral valve repairs.
3. “Robotic Radical Retropubic Prostatectomy,” by M. Menon, British Journal of Urology, February 2003. A report on open, laparoscopic and robotic surgeries that provides evidence that patients suffer the least blood loss and endure the shortest hospital stays after robotic surgery
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Photographs by Max Aguilera-Hellweg |
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