[pav345678]

Actually, it is compelling. All things being equal you give an experienced surgeon an advanced tool and get 30% reduction in hospital stay along with less damage to your kidney function

From a patient point of view it is a big difference. Hospital stay is really expensive even if you have insurance. Hospitals charge like 10000$ per day and copayment foe hospital stay is usually hundreds of dollars.

Of course, it means that hospitals can process more patients and generate more profit, but it also reduces surgery wait times, which is critical for a patient with a tumor, because the longer your wait, the more likely for the tumor to spread

[iancmceachern]

That's the thing, they're aren't any studies that have true statistical significance that show the claims you state here.

That's the rub, what I'm highlighting. We all just automatically assume the robot is better because it's a robot. The proof is in the pudding.

[pav345678]

No, we don't assume that its is better because it is robot. We assume it is better because it was specifically designed to give to a surgeon a better instrument. It allows more range of instruments movement and degree of freedom and eliminates issues with surgeon hands trembling.

Yes, there is no statistically significant evidence yet that it is better, but there is no statistical evidence that it is worse. I don't think it is beneficial to stop using this technology based on cost effectiveness.

I happened to had a tumor on my kidney 6 month ago, so I actually had to make a decision between regular laparoscopy and Da Vinci. Tge surgeon who did not have access to the robot system said that robot is just marketing BS and he would do a surgery just fine. However, because the tumor was on the back side of the kidney it would require rotating kidney out of the place and would be a bit challenging. But he was confident that it could be done

THe surgeon with robot said that tumor position is not a problem for a robot whatsoever. So I went with the robot.

So, back to OP, the robot is better because it allows to perform surgery in places where it is not possible to go with non robotic instruments.

I also have plenty of anecdata from people who had similar surgeries performed on them with different techiques. It terms of post op recovery da Vinci wins unanimously. I had surgery on Tuesday and was back to work next Monday

[coldtea]

>No, we don't assume that its is better because it is robot. We assume it is better because it was specifically designed to give to a surgeon a better instrument.

All kinds of things have been designed to "specifically give to an X profession a better instrument".

That's just a mission statement at best, marketing promo at worst. Doesn't preclude them not meeting that target.

"it's better because it has been specifically designed to be better" is circular reasoning.

[iancmceachern]

It does allow for improvements in surgical technique in some ways, it introduces severe limitations in other ways.

Many of the positives you highlight are true for any modern laporoscopic surgury, not just Da Vinci. In most indications, manual laparoscopy is by far the market volume leader for lots of reasons. Reasons like big surgical systems like Da Vinci are huge and require dedicated large ORs that are expensive. Meanwhile they still need to get surgury done in the smaller, more common, more cost effective ORs. Don't get me wrong, Da Vinci is a modern marvel, as I've said in other comments here it's truly a remarkable work of engineering. Its also a monopoly that makes a ton of money, and also far from how every surgery is done or should be done. Those two things don't go together, monopoly and shouldn't be the whole market. That's all I'm saying. It's not the panacea it's made out to be often.

[robotresearcher]

I have some robot experience, so I assume any robot is hot garbage until proved otherwise. In the links you've provided, the robot seems to do better than baseline in prostate surgeries, and is now the standard approach.

[coldtea]

>Actually, it is compelling. All things being equal you give an experienced surgeon an advanced tool and get 30% reduction in hospital stay along with less damage to your kidney function

First you have to trust the surgeon not to be shilling in his report.