by
Nancy Ryerson, Staff Writer | March 11, 2013
From the March 2013 issue of HealthCare Business News magazine
“When I look back at when we started in 2004, it was really kind of a gut check to say I’m going to immerse myself in this, and I’m going to provide this as a primary therapy and put aside what I was doing in the past,” says John Valvo MD, division chief of robotics at Rochester General Health System.
There isn’t a standard for robotic surgery training, but by using a grant from the U.S. government, Patel’s team is developing a list of fundamental tasks that any surgeon has to pass in order to perform robotic surgery. The Global Robotics Institute works with a virtual reality company called Mimic to recreate the experience of performing robotic surgery so physicians have plenty of time to practice before getting behind the console to perform a procedure.
“Surgery is often known as see one, do one, teach one, which obviously doesn’t make sense for the surgeon or the patient,” says Patel. “In the future, we want it to be see one or see many, simulate 100, then under proctorship, do one.”
Intuitive Surgical also offers training for surgeons, residents, fellows and surgical assistants.
Despite the challenge, surgeons generally find the extra training is worth the comfort robotic surgery offers. Instead of standing hunched over for hours, surgeons sit for the length of the surgery. Robotic surgery is also more ergonomic for the wrists, hands and neck, and after achieving the learning curve, most surgeons find that their robotic surgery time is either the same or shorter than their open surgery time.
“Standing on your feet for four or five hours tearing into a wound is a very uncomfortable and unnatural position,” says Michael D. Stifelman, associate professor, Director of Robotic Surgery, Department of Urology at NYU Langone Medical Center. “In robotics there’s a lot less stress on the body.”
Putting robots to the test
Even with the apparent advantages, cost and questions about the value are still major roadblocks to a complete robotic takeover of medicine – a da Vinci robot system runs for more than $1 million. Because surgical robots have only been in use for a decade or so, there has not been enough time for clinical trials to reveal results until now. Most studies done in the past reflect the experiences of only one institution, leading skeptics to conclude that successful results could be the work of a skilled surgeon, not the robotic system.
“People would say you can’t use these studies to generalize, but up until 2012, there really was no other form of evidence out there,” says Intuitive’s Mohr. "In 2012, however, several studies using large population-based data came out definitively showing the benefit of using surgical robots for many surgeries."
