July 27, 2017

32 Years Later: Has Robotic Surgery Fulfilled its Promise?

Viewpoints from Steven Wexner, MD

17-DDI-3695-Wexner-Robotic-Surgery

The first robotic surgical system was introduced in 1985 and the first iteration of the current platform became available for colorectal surgery in 2001.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

A study asks: “Is it worthwhile?”

To evaluate any potential advantages of the robotic platform as compared with traditional open and non-robotic minimally invasive surgical techniques, Tan and coworkers from the Imperial College in London performed a systematic review and meta-analysis.

The authors were able to identify 99 relevant articles in which the data on 14,448 patients were included. The authors assessed many types of resection including proctectomy, colectomy, thyroidectomy, prostatectomy, cystectomy, nephrectomy, vasovasotomy, vasoepididymostomy, coronary artery bypass graft, anterior mediastinal mass resection, endometrial cancer staging, hysterectomy, total hip arthroplasty, unicompartmental knee arthroplasty, total knee arthroplasty and spinal pedicle screw insertion.

A variety of robotic platforms and trial designs were included. The authors compared the robotic platforms with both open and non-robotic minimally invasive surgery and included both prospective and prospective randomized controlled trials. They were able to identify a reduction in blood loss and transfusion with the robotic platform and noted the robotic platform afforded a decreased length of hospitalization and decreased overall complication rate than as compared to open surgery.

Advertisement

The common denominator — and an eye toward the future

Unfortunately, the authors found that these advantages were not shown within the prospective randomized controlled trials.

The common denominator that they found throughout these 99 articles (covering a wide array of surgical procedures) was a significantly increased length of surgery.

I am impressed by the honesty of the authors, including my good friend and respected colleague, Lord Ara Darzi of Denham. His group at the Imperial College in London have been staunch proponents of robotics and have for many years organized and hosted the superbly high quality annual Hamlyn Symposium in London. They are at the cutting edge of robotics well beyond the current surgical platforms.

Advertisement

Hopefully, with collaboration amongst surgeons, engineers and other stakeholders, future iterations of robotic systems will consistently show clinically significant benefits.

Related Articles

Doctor talking with patient
February 21, 2024
Consider Risk Factors When Deciding Care Path for Postoperative Crohn’s Disease

Strong patient communication can help clinicians choose the best treatment option

Liver disease
August 17, 2023
Diagnosis and Management of Ascites, Spontaneous Bacterial Peritonitis and Hepatorenal Syndrome

Brief pearls for diagnosis and management of ascites and relevant conditions associated with decompensated cirrhosis

22-DDI-3283958 CQD Neuro GI program preview-Gabbard
January 6, 2023
New Neurogastroenterology and Motility Center Provides Coordinated Care

Hard-to-treat GI disorders benefit from multidisciplinary approach

The Featured Image for the post
July 26, 2021
The Role of the Clinical Pharmacist in an IBD Medical Home

How an IBD specialist pharmacist enhances patient care

20-DDI-1971367-CQD-Tunneled-Intravenous-Catheters
October 27, 2020
Risk of Deep Vein Thrombosis in Patients with IBD: Choosing a Catheter for Parenteral Nutrition

Rate is lower with tunneled intravenous catheters

20-DDI-1887417-Rizk_whatIsACO-FAQs-CQD-650×450
July 24, 2020
Enhancing Quality and Value of Care through Accountable Care Organization Relationships

Cleveland Clinic’s ACO takes a team of teams approach

20-DDI-065 Complex hernia repair hero 650×450
April 7, 2020
Case Report: Complex Hernia Repair Involving Pelvic and Bladder Reconstruction

A multispecialty team was essential for this challenging case

19-DDI-244-Driving-Sedated-CQD
January 20, 2020
Driving After Endoscopic Procedural Sedation: Is a 24-hour Ban Too Long?

Cleveland Clinic study assesses psychomotor recovery

Ad