Is Robotic Surgery Safe?

A recent report released from the CDC revealed findings researchers from three medical research centers concluded regarding the safety of robotic surgery. The report caused quite a gasp because it revealed that robotic procedures performed from 2007 and 2012 had over 8,061 device malfunctions, resulting in 1,391 injuries and 144 deaths.

Now at first glance, of course these are shocking and concerning numbers. Researchers from the University of Illinois at Urbana-Champaign, Massachusetts Institute of Technology and Chicago’s Rush University Medical Center, noted some of the malfunctions listed in the report were equipment sparking during an operation, loss of video feed and uncontrollable movement of the robotic instruments.

Since the da Vinci Surgery System was approved by the FDA in 2000, robotic surgery has received criticism and concern from the medical community. I was one of the first surgeons to ever perform a robotic prostatectomy (removal of the prostate) and as a surgeon who does this every day, I can tell you, in the hands of experienced surgeons, robotic surgery continues to be a very safe procedure.

So all it takes is a fancy robot?

Absolutely not. What it takes is an experienced surgeon.

Think of the robot as an extension of our arms. But having an extension of our arms doesn’t diminish the skill and experience surgeons need in order to successfully perform these procedures and give the patient the best outcome. Experience matters above all else when it comes to surgery. Robotic surgery at the end of the day is an advancement in technology. A skilled surgeon plus the technology of robotics, will result in a positive outcome as opposed to a surgeon who is not well-trained and inexperienced. This is quite dangerous.

Believe it or not, some surgeons take a weekend course and return to the OR on Monday claiming they’re “robotic surgeons.”

So what are the benefits of robotic surgery?

First of all, robotic surgery gives far greater precision than open or even laparoscopic technique. This leads to the outcome we’re looking for in regards to curing the patient from cancer. The robot is also equipped with 3x magnification and a better range of motion. If used properly by a skilled surgeon, robotic surgery is a major upgrade from open surgery. Open surgery creates a lot of the blood in the surgical field and requires the surgeon to use their hands for tactile feedback in order to progress the procedure. But this can cause a lot of unnecessary damage.

My experience in the operating room coupled with the ability to treat and counsel patients is significantly improved with the robot. For prostate cancer surgery, I’m able to navigate delicate prostate tissue and nerves much easier and ultimately I can ensure all of the cancer is removed.

So when does robotic surgery cause issues for patients?

It’s simple, when robotic surgery is in the hands of inexperienced surgeons. The authors of this study even show that the data still doesn’t fully confirm the source of the fault with regards to the injuries and deaths that happened during an operation. Was it the surgeon, surgery team or solely the device? Even as rare as robot malfunctions are, inexperienced surgeons jumping behind the robot, unaware on how to fully operate it could be linked to these incidents.

Every surgeon should be fully committed to their patient, leading them to the best outcome. The entire case should be performed by the same surgeon from beginning to end.

The big question really remains: What if the robot breaks during surgery? Ask your surgeon if they’re equipped to switch over to laparoscopic technique or covert to open surgery in an instant, if necessary.  I happen to be trained in all three techniques. Not all are. 

The truth is any operation can be unpredictable and often the surgeon cannot foresee every possible situation that could arise during the procedure. Having the experience and knowledge of these varied cases sets a skilled robotic surgeon apart from the rest.

Robotic surgery as a technique is continuing to expand around the world. We just launched our new Institute of Robotic Surgery at the Mediterranean Hospital of Cyprus in Limassol and the very first SMART Robotic Surgery (Samadi Modified Advanced Robotic Technique) was performed in Cyprus as well as the first robotic prostatectomy in Limassol.

This technology has vastly improved many otherwise difficult procedures, prostastectomy being one of them. Shorter hospital stays, less blood loss, faster recovery, and ultimately a better quality of life are what the majority of men experience after the surgery. Robotic surgery delivers optimal urinary health and sexual function for life after prostate cancer, which is just as important as being cured from cancer. 

Patients need to be aware that it is not a robot that performs the surgery; it’s the surgeon behind the robot. Inexperienced surgeons plus the technology means a lot of complications will arise. The key message here is that patient’s need to do extensive research before selecting a surgeon. Every robotic surgeon must be experts in their respective fields whether it’s urology or gynecology. Also, it’s important to find out how many cases they’ve performed as well as their level of experience and patient outcome rates. Even further, understanding how your surgeon prepares you for the surgery as well as the follow-up care to be expected are equally important to your results. Ask questions. If all that checks out, then and only then will an experienced surgeon have the tremendous benefits the robot brings.