FRIDAY, May 20 (HealthDay News) -- Many hospitals tout the
benefits of robotic surgery on their websites without solid
scientific evidence to back up those claims, Johns Hopkins
In fact, four out of 10 hospitals in the study only used
manufacturers' claims that robotic surgery is better than
conventional surgery, an assertion that the researchers said is
unproven and misleading.
The findings are especially troubling since consumers depend on
hospital websites for reliable, trustworthy information, the study
"Hospital websites are a trusted source of medical information for the public," said lead researcher Dr. Marty Makary, an associate professor of surgery at Hopkins.
"This is the first time we've seen industry create content, with disclosures, and put it on the official hospital website to educate patients about treatment options," he said. "To me, that's a very scary trend."
Robotic surgery has grown more than 400 percent over the past
four years, Makary pointed out. "It's one of the great modern
crazes," he said. "And the public is driven by the idea that more
technology means better care."
Proponents say robot-assisted surgeries require smaller
incisions, are more precise and result in less pain and shorter
hospital stays. The study authors said those claims are
The growth of robotic surgery has been driven by hospital
marketing, Makary said. "Marketing a robot has become a very
successful strategy for hospitals. It implies the hospital has
state-of-the-art care," he said. "Patients may perceive the
hospital is on the cutting edge because they do robotic
Makary noted that often hospitals do not mention the material on
their website was provided by the manufacturer, and the sites often
fail to mention the risks associated with robotic surgery. Risks
include being under anesthetic longer and needing to have a second
incision to place the robotic arm, he said.
In addition, the researchers looked at the claims made about the
benefits of robotic surgery on these sites. "Frankly, the claims
are overstated," Makary said. "Improved cancer outcomes -- that's
Thirty-two percent of the sites claimed that robotic surgery
improved cancer outcomes, the researchers found. Makary pointed out
that in the studies of robotic surgery, patients suffer as many
complications as they do with conventional surgery.
Eighty percent of the robotic surgeries done in the United
States are urological and gynecological, Makary said. There have
been no randomized trials in these areas comparing robotic and
conventional surgery, he said.
"To me, this is exactly what is wrong with American health care," Makary said. "We are adopting technology without being up front about the outcomes to consumers. And we adopt technology before we properly evaluate it."
The report is published in the May online edition of the
Journal for Healthcare Quality.
For the study, Makary's team looked at the websites of 400
hospitals with 200 beds or more. They looked for whether robotic
surgery was available and what information was provided on the
hospital's website in June 2010.
They wanted to see how many hospitals used photos and text
directly from the manufacturer of the device and what claims were
made about the efficacy of robotic surgery.
The researchers found 41 percent of the websites detailed the
availability of robotic surgery and how it worked. In addition, 37
percent of these sites had the information on the home page and 66
percent had a link to another page.
The information on 73 percent of these sites came directly from
the manufacturer and 33 percent offered a direct link to the
manufacturer's site, Makary's group found.
Moreover, 89 percent of these sites said that robotic surgery
was better than conventional surgeries. The claims included less
pain (85 percent), shorter recovery (86 percent), less scarring (80
percent) and less blood loss (78 percent). No hospital website
mentioned risks associated with the surgery.
Chris Simmonds, senior director of marketing services at
Intuitive Surgical Inc., the maker of the da Vinci Surgical System,
which is the most widely used robotic system, acknowledged that the
company does provide ready-made marketing materials for hospital
Simmonds disputed Makary's findings, however.
The evidence of the benefits of robotic surgery is
well-documented, Simmonds said. "All the indicators in terms of
length of stay, blood loss, complications and cancer control are
all better," he said. The company does tell hospitals the system
does provide better patient outcomes, he said.
Dr. David B. Samadi, chief of robotics and minimally invasive
surgery at Mount Sinai Medical Center in New York City, said that
"there is some truth to what Makary says."
"There is a lot of misinformation on some of the websites out there, and patients have to really dig in and make sure the information is correct," he said.
However, the key to successful robotic surgery is the same as
any other surgery, namely the skill and experience of the surgeon,
Samadi said. "This technology in the hands of an experienced
surgeon is a great tool, but if you don't have the adequate
training it could be quite dangerous," he said.
The procedure is being oversold, Samadi added, and it is
sometimes being done by inexperienced surgeons.
"It's up to patients to get a second opinion," he said. Before undergoing robotic surgery, patients need to understand the risks and benefits and be confident that the surgeon is well-trained and performs many such procedures each year, he said.
For more information on robotic surgery, visit the
U.S. National Library of Medicine.
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