The da Vinci surgical system is believed to be a one-of-kind medical breakthrough in the field of robotic-assisted surgery. Assisting in more than six million procedures to date, the da Vinci allows surgeons to perform high-risk procedures with minimally invasive methods. Manufacturers of the da Vinci claim it could one day change the landscape of all surgery, reducing the number of complications leading to life-threatening injuries.
Despite these advances, the da Vinci robot is far from perfect. U.S. News and World Report has reported that more than 20,000 people have been injured in the last 10 years from malfunctions and errors related to robotic-assisted surgery. At least 274 of these patients died from their injuries, and some during minor and routine procedures.
According to a 14-year study of data collected from the Food and Drug Administrations (F.D.A.) on the adverse reactions of surgical robots, the most common injuries during robotic-assisted procedures include:
- nicked blood vessels
- perforated organs
- trauma injuries from dropped instruments
If you or a loved one has been considering robotic-assisted surgery, know the risks before you go under the robot. We are in no way giving medical or surgical advice. However, as community health and safety advocates, we believe it is critical for all patients to stay informed. These are the factors to consider.
The Dangers of Surgical Robots
The da Vinci system was commercially available in the United States in 2000 and became the first robotic surgical platform to be cleared by F.D.A. for use in general laparoscopic surgery. Yet, even after 20 years on the market, there are numerous risk factors that are causing patients harm:
There is no standardized training or credentialing program for procedures utilizing surgical robots such as the da Vinci system. Current practice in the surgical field requires hospitals that purchase surgical robots to train the physicians who will be using them properly. With a lack of comprehensive best practices and procedures to follow, this can result in a number of lapses in policies that could cause preventable medical errors to occur.
Surgeons who are mid-career and picking up the controls of surgical robots are reporting high levels of stress during robotic-assisted procedures. Unlike traditional surgery, the chance of malfunctioning equipment and errors is an additional and unpredictable risk to plan for. Surgeons using the da Vinci system are also highly dependent on surgical assistants during procedures. If a physician’s assistant does not place the camera correctly or lacks effective communication with the surgeon, the procedure is not likely to be successful.
Surgical robots are machines, meaning they are susceptible to breaking and defects no matter how expensive or sophisticated.
The 14-year study of F.D.A. injury reports highlighted the following errors during robotic-assisted surgeries that have led to health complications, injury, and death:
- System errors and faults
- Loss of video display
- Blurry camera images
- Broken pieces falling into patients
- Additional operation time needed to find instruments that fell (could include having to open up patient)
- Broken tips on surgical instruments
- Electrical arcing, sparking, or charring of equipment
- An unintended or unstoppable movement
- Instruments that are not recognized by the system
- Instruments that fail to open or close
- Cable or wire damages
- Issues with electrosurgical units
When surgeons are holding tools in their hands, they can feel the pressure they are putting on a patient’s body. But when using surgical robots, this natural sensation is absent. Some surgeons have put too much pressure on a body part when unknowingly, causing accidental tears and punctures.
Surprisingly, surgical procedures performed by the da Vinci system are typically longer. According to Drugwatch, the longer a patient is under the knife, the more at risk they are for medical errors. Long procedure times can also lead to higher volumes of anesthesia and more chances for adverse reactions and errors to occur.
High Expense- No Guarantee
Robotic-assisted surgeries can be thousands of dollars more than procedures using less advanced laparoscopic technology. But the price does not guarantee a successful result. Some hospitals push surgeons to recommend surgical robots for minimal procedures with no obvious benefit to the patient but at double or even triple the cost.
Benefits of Surgical Robots
The news about surgical robots is not all negative. There have been millions of successful surgeries performed using surgical systems such as the da Vinci, and chances are more advanced models are on the way.
Physicians may recommend robotic-assisted surgery for several reasons, including:
- reduced blood loss
- smaller incisions and exposed surgical sites
- minimal scarring
- lower risk for infections
- shorter recovery times
Not all patients are ideal candidates for robotic-assisted surgery. According to a study published by the JAMA Network, the following factors can put individuals at a higher risk for complications:
- renal comorbidity
- malignant disease
- cardiovascular disease
- Individuals over the age of 70
- BMI score of 30 or less
- ASA score of 3 or greater
Patients undergoing advanced procedures may also not be the best candidates for robotic-assisted surgeries. In February of this year, the F.D.A. cautioned breast cancer patients against opting for mastectomies performed by surgical robots. Due to a lack of evidence that surgical robots were more effective in removing this type of cancer, the agency warned undergoing robotic-assisted procedures could reduce the survival rate of these individuals.
Signing up for the newest and most advanced procedure may not increase your chances of a successful surgery. Talk to your doctor about all of the options available for your procedure to make an educated decision about your health. Ask questions and get a second opinion to ensure you are making the right choice for your unique situation.
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