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“Aggressive and Misleading” Marketing of Robotic Hysterectomy

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March 21, 2013 — Tens of thousands of women are choosing robotic surgery for hysterectomies (removal of the uterus) with the Da Vinci Robotic Surgery System. These women are often told that a robotic hysterectomy will provide a “better overall experience” with fewer complications and faster recovery.

This is true when robotic hysterectomies are compared to older, abdominal-incision hysterectomies. However, today, more than 80% of hysterectomies are performed through minimally-invasive laparoscopic surgery. When robotic hysterectomies are compared to laparoscopy, researchers have found minor additional benefits for the patient, but significantly higher costs.

Some experts are concerned that women are being misled by “aggressive” marketing into choosing a new, unproven technology that has a long learning curve for surgeons and unique complications (such as mechanical malfunctions).

The president of the largest association of obstetricians and gynecologists, Dr. James T. Beeden of the American Congress of Obstetricians and Gynecologists, published an editorial in March 2013 in which he warned:

“Robotic surgery is not the only or the best minimally invasive approach for hysterectomy. … Aggressive direct-to-consumer marketing of the latest medical technologies may mislead the public into believing that they are the best choice.”

Many OB/GYNs and experts are concerned about the lack of evidence to support marketing claims for the majority of women who undergo a robotic hysterectomy. Hospitals frequently claim the Da Vinci robot provides benefits, such as:

  • Better overall experience
  • Smaller incision (1/2 inch) than abdominal hysterectomy
  • Less invasive
  • More surgical precision and range of movement
  • Less blood loss
  • Less post-operative pain and medications
  • Lower risk of complications and infection
  • Faster recovery time (usually about one week)
  • Shorter hospital stay
  • Less scarring

However, in February 2013, a study published in Journal of the American Medical Association called these marketing claims into question. When researchers compared robotic hysterectomies to laparoscopic hysterectomies, they found that the procedures offered similar patient outcomes, but robotic surgery was significantly more expensive:

  • Overall Complication Rate: 5.3% for laparoscopic hysterectomy, 5.5% for robotic hysterectomy.
  • Hospitalization for more than two days: 24.9% for laparoscopic hysterectomy, 19.6% for robotic hysterectomy.
  • Blood transfusion: 1.8% for laparoscopic hysterectomy, 1.4% for robotic hysterectomy.
  • Need for nursing facility care: 0.3% for laparoscopic hysterectomy, 0.2% for robotic hysterectomy.
  • Cost: On average, robotic hysterectomy was $2,189 more expensive for the patient than laparoscopic hysterectomy.

In conclusion, the researchers warned:

“Robotically assisted and laparoscopic hysterectomy had similar morbidity profiles, but the use of robotic technology resulted in substantially more costs.”

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