Robotic Surgery: A Current Perspective

Anthony R. Lanfranco, BAS; Andres E. Castellanos, MD; Jaydev P. Desai, PhD; William C. Meyers, MD

Disclosures

Annals of Surgery. 2004;239(1) 

In This Article

Disadvantages of Robot-Assisted Surgery

There are several disadvantages to these systems. First of all, robotic surgery is a new technology and its uses and efficacy have not yet been well established. To date, mostly studies of feasibility have been conducted, and almost no long-term follow up studies have been performed. Many procedures will also have to be redesigned to optimize the use of robotic arms and increase efficiency. However, time will most likely remedy these disadvantages.

Another disadvantage of these systems is their cost. With a price tag of a million dollars, their cost is nearly prohibitive. Whether the price of these systems will fall or rise is a matter of conjecture. Some believe that with improvements in technology and as more experience is gained with robotic systems, the price will fall.[6] Others believe that improvements in technology, such as haptics, increased processor speeds, and more complex and capable software will increase the cost of these systems.[9] Also at issue is the problem of upgrading systems; how much will hospitals and healthcare organizations have to spend on upgrades and how often? In any case, many believe that to justify the purchase of these systems they must gain widespread multidisciplinary use.[9]

Another disadvantage is the size of these systems. Both systems have relatively large footprints and relatively cumbersome robotic arms. This is an important disadvantage in today's already crowded-operating rooms.[9] It may be difficult for both the surgical team and the robot to fit into the operating room. Some suggest that miniaturizing the robotic arms and instruments will address the problems associated with their current size. Others believe that larger operating suites with multiple booms and wall mountings will be needed to accommodate the extra space requirements of robotic surgical systems. The cost of making room for these robots and the cost of the robots themselves make them an especially expensive technology.

One of the potential disadvantages identified is a lack of compatible instruments and equipment. Lack of certain instruments increases reliance on tableside assistants to perform part of the surgery.[6] This, however, is a transient disadvantage because new technologies have and will develop to address these shortcomings.

Most of the disadvantages identified will be remedied with time and improvements in technology. Only time will tell if the use of these systems justifies their cost. If the cost of these systems remains high and they do not reduce the cost of routine procedures, it is unlikely that there will be a robot in every operating room and thus unlikely that they will be used for routine surgeries

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