"Robotic surgery draws following despite little study; Outcome’s quality over traditional method is unclear" by Gina Kolata, New York Times | February 14, 2010
NEW YORK - At 42, Dr. Jeffrey A. Cadeddu feels like a dinosaur in urologic surgery. He was trained to take out cancerous prostates the traditional laparoscopic way: making small incisions in the abdomen and inserting tools with his own hands to slice out the organ.
But now, patient after patient is walking away. They do not want that kind of surgery. They want surgery by a robot, controlled by a physician not necessarily even in the operating room, face buried in a console, working the robot’s arms with remote controls....
On one level, robot-assisted surgery makes sense. A robot’s slender arms can reach places human hands cannot, and robot-assisted surgery is spreading to other areas of medicine.
But robot-assisted prostate surgery costs more - about $1,500 to $2,000 more per patient. And it is not clear whether its outcomes are better, worse, or the same.
I thought health care was where the future jobs were supposed to be.
And there are some of your rising costs right there.
One large national study, which compared outcomes among Medicare patients, indicated that surgery with a robot might lead to fewer in-hospital complications, but that it might also lead to more impotence and incontinence.
I'll pass then.
But
No, no buts.
the study included conventional laparoscopic surgery patients among the ones who had robot-assisted surgery, making it difficult to assess its conclusions.
Not for me:
"doctors inadvertently cut Mr. Murtha's intestine during the laparoscopic surgery"
Related: Medicare No Advantage For Seniors
And if he can't get good care, why do we want to go national?
It is also not known whether robot-assisted prostate surgery gives better, worse, or equivalent long-term cancer control than the traditional methods, either with a 4-inch incision or with smaller incisions and a laparoscope. And researchers know of no large studies planned or underway.
Marketing has moved into the breach, with hospitals and surgeons advertising their services with assertions that make critics raise their eyebrows....
Then it's time for you to MOVE OUT, patients.
I don't make "trade-offs" with my health, sorry.
Ordinarily, doctors can feel how forcefully they are grabbing tissue, how well they are cutting, how their stitches are holding. With the robot, that is lost.
If you hear an "Ooops" from the speaker that's a bad thing.
And the robot is slow; it typically takes 3 1/2 hours for a prostate operation, according to Intuitive, twice as long as traditional surgery.
Doc, why don't you just come on in the room and perform the $urgery your$elf?
Oh, right.
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Don't let 'em scan you, either:
"Use of MRI, CAT scans rising in hospital emergency rooms" by Mike Stobbe, Associated Press | February 18, 2010
ATLANTA - The scans are expensive - a single CAT scan can cost $500 to $1,000, and MRIs and PET scans can be much more expensive. The federal Medicare program has been trying to hold down imaging costs since its annual bill reached $12 billion.
Studies have not yet clearly demonstrated that the scans are lowering death rates, said Dr. Rita Redberg, who is editor of the Archives of Internal Medicine and a cardiologist at the University of California, San Francisco.
There also is concern about radiation from scanners.
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How long have those things been in use?
"CT scan makers to install radiation controls" by Associated Press | February 26, 2010
WASHINGTON - Last year, three California hospitals reported hundreds of acute radiation overdoses from CT scanners, with many patients reporting hair loss and skin redness.
The average American’s total radiation exposure has nearly doubled in the past three decades, largely because of next-generation imaging tests, according to the FDA....
Related: AmeriKa's Cancer-Causing Hospitals
The safety changes outlined by the industry will be made to older machines via software changes, though the effort will take time.
“It’s important to understand that this is a rolling initiative,’’ said Dave Fisher, executive director of the alliance. “It won’t happen overnight.’’
Now hold still, patient.
Zzzzzzzzzzzzzzzzztttt!
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