The DaVinci Robot: Reducing Recovery Time and Medical Costs in the Operating Room

Author:  Somnay Yash
Date:  May 2008

With the rising costs of medical care, healthcare recipients as well as medical specialists are putting an increasing emphasis on treatment options that curtail the amount of necessary post-operational care. The invention of the DaVinci robot is rapidly becoming to be the surgeon's first hand companion in the operating room, from cardiac bypasses to hysterectomies to prostatectomies. With its ability to facilitate surgical procedures with minimal incisions, the DaVinci robot is pioneering a new era of medical practice. Patients now recover faster and stay in the hospital for shorter periods, effectively reducing the long term medical care expenditures.

The DaVinci robot received governmental approval in 2000, and to this day, is the only "low-trauma" surgical robot technology on the market. With a cost of more than $1.5 million for each robot, the DaVinci robot will be sold by its makers, Intuitive Surgical®, worldwide, including approximately 647 in the United States alone.

Both the health, strategic and economic benefits of the DaVinci robot and other robotic guided medical technologies may offset the exorbitant costs of the robots in the first place. According to Dr. Robert S. Poston, a cardiac surgeon at the University of Maryland Medical Center, each cost of the bypass is increased by approximately $8,000 with the advent of robotic assisted surgical implementations. Dr. Poston also mentions that apart from the reduced necessity for additional patient care, long term costs are also reduced by avoiding the potential for post op-complications that usually occur among high risk patients.

Despite the DaVinci robot's extensive use in prostate surgery, a handful of medical centers are using the robot for heart bypass surgeries, mitral valve repairs and other cardiothoracic operations. Among these pioneering institutions is the University of Maryland Medical Center, where researchers surveyed 100 patients receiving the minimally invasive surgery. Among them, the average length of hospitalization after surgery was about four days; much shorter than the standard seven day post-op recovery period. Among high risk patients, the difference was more apparent- a five day recovery period as opposed to the usual twelve day period.

Furthermore, about 44% of patients experienced complications after traditional surgical procedures, compared to the mere 22% among patients receiving DaVinci robot assisted surgery.

This research also focused on the narrowness of grafted vessels around blocked arteries among patients receiving cardiac bypass surgeries. A computed axial tomography (CAT) scan revealed much less clotting in the bypass grafts from robotic guided surgery patients than from traditional bypass surgeries. Dr. Bartley Griffith, head of Cardiac Surgery and professor of medicine at the University of Maryland Medical Center, said, "We saw a long term benefit to patients after their bypass in terms of the patency, or openness, of the bypass graft."

This finding can be attributed to the surgeon's ability to easily access two internal mammary arteries to construct new bypass vessels as opposed to removing sections from exogenous veins. The superior quality of the bypass vessel construction enables patients to recover faster and experience more reliable and long-term benefits from robotic assisted surgery.

Despite the promise of the DaVinci robot, many surgeons believe that logistical factors of implementing widespread standardization of robotic techniques must be heavily weighed. Bruce Fye, a Mayo Clinic heart specialist and medical historian said, "It's terrific to say, Gee whiz, why don't I have a robotic operation when the aternative is taking a chain saw to my chest?' But there are too many places that won't have the volume or surgeons with the interest or expertise to make it a logical choice."

Similarly, many other surgeons concur with Fye's statement. Hospitals may be too slow to adopt robotic surgeries since there is a deficit of tech savvy surgeons and far too few ideal candidates available for robotic assisted operations. It will be interesting to see how this technological advance will react with the hard realities of current medicine. Perhaps a modified approach to medical education must systematically employ a greater emphasis on the increasing prevalence of technological interventions. This approach may train the next generation of surgeons to be technologically adept enough to allow robotic surgery to enhance the face of medicine.

Written by Yash Somnay

Reviewed by Muhammed Ziadh

Published by Pooja Ghatalia.