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Review of studies finds robotic-assisted abdominopelvic surgery not superior to laparoscopy or open surgery

Photo showing Naila H. Dhanani, a third-year resident with McGovern Medical School at UTHealth in Houston, who led research on robotic-assisted abdominopelvic surgery outcomes and cost. (Photo by UTHealth)
Naila H. Dhanani, a third-year resident with McGovern Medical School at UTHealth in Houston, led research on robotic-assisted abdominopelvic surgery outcomes and cost. (Photo by UTHealth)
Naila Dhanini, MD (Photo by UTHealth)
Naila Dhanini, MD (Photo by UTHealth)

Robot-assisted abdominopelvic surgery did not have clear clinical benefits over either laparoscopy or open surgery, despite a higher price tag, according to research from The University of Texas Health Science Center at Houston (UTHealth).

Led by Naila H. Dhanani, MD, a third-year resident with McGovern Medical School at UTHealth, the study published recently in Annals of Internal Medicine also reported that robot-assisted surgery took slightly longer than laparoscopy.

“We were motivated to perform this review given the rapid adoption of robotic surgery worldwide and wanted to ensure there was high-quality evidence available to support this growth,” Dhanani said. “Our review failed to find such evidence.”

The researchers performed a systemic review of all randomized, controlled trials comparing robotic to either laparoscopic or open abdominopelvic surgery. The resulting 50 published reports involving 41 studies included 4,898 patients. The subspecialty surgeries included were anti-reflux, gastrointestinal, colorectal, urology, and gynecology.

The initial cost of the most prevalent robotic platform is $1.5 million, the authors wrote. Training sessions for operating room teams, replacing disposable instruments, and service contracts are additional costs.

With more competition among companies with robotic platforms, and improvements in technology, the researchers anticipated that costs will drop. The study also concluded that robotic-assisted surgery is safe and effective.

“All clinicians have an important role to play in ensuring the safe adoption of new technologies, particularly those that are not yet supported by high-quality evidence,” Dhanani said.

UTHealth co-authors from the Department of Surgery at McGovern Medical School were Julie Holihan, MD, MS, assistant professor of surgery; and Oscar Olavarria, MD, resident.

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