$ISRG – great marketing, average results.

Doctors often recommend surgery when medicine and lifestyle changes cannot ease your abdominal or gastrointestinal symptoms. If your doctor recommends surgery, learning about all surgical options can help you to make the best decision for your situation.

Surgery is often an effective treatment for many abdominal and GI conditions, but traditional open surgery with a large incision is highly invasive. Open surgery may also require a long hospital stay and lengthy recovery.

Fortunately, there are minimally invasive surgical options. The most common is laparoscopic surgery (laparoscopy). Surgeons make a few small incisions and insert a tiny camera and long-handled instruments to reach inside your abdomen. The camera transmits images onto a video monitor in the operating room to guide surgeons as they operate. Traditional laparoscopy is effective for many routine procedures but the rigid surgical instruments can be technically challenging for delicate or complex operations.

da Vinci Surgery is another minimally invasive option for patients facing abdominal or gastrointestinal surgery. Instead of a large abdominal incision used in open surgery, da Vinci surgeons make a few small incisions – similar to traditional laparoscopy. However, the da Vinci System features a magnified 3D high-definition vision system and special wristed instruments that bend and rotate far greater than the human wrist. As a result, da Vinci enables your surgeon to operate with enhanced vision, precision, dexterity and control.

State-of-the-art da Vinci uses the latest in surgical and robotics technologies and is beneficial for performing complex surgery. Your surgeon is 100% in control of the da Vinci System, which translates his or her hand movements into smaller, more precise movements of tiny instruments inside your body.


Sounds great! Less scarring, I make it easier for my surgeon than having to use those bulky tools, and I’ll decrease my hospital stay and recovery! Its a robot that my surgeon is “100% in control of… for more precise movements!” Sign me up!

Then, you see (yet another) study like this

Today’s discussion is on a multicenter study comparing 223 robotic performed gastrectomies vs 221 laparoscopic gastrectomies, where patients were matched according to the surgeon, extent of gastric resection, and sex, and the primary outcome was morbidity and mortality. Overall complication rates were similar (11.9% for robotics vs 10.3%), which major complications being 1.1% for both groups. Length of procedure was significantly longer for the robotic group (221 minutes vs 178 minutes), with, obviously, significantly higher costs in the robotic arm ($13,432 vs $8090 USD). There was no significant difference between estimate blood loss, rate of conversion to open procedure, diet build-up, or length of hospital stay.

In case you were wondering, as of June 4, 2015, Intuitive Surgical- the maker of the da Vinci – has a market cap of 18 billion dollars, while comparatively, TeamHealth and Envision (ie, EMCare) – the two largest EM staffing companies in the US, are valued at 4 billion and 7 billion, respectively.

At over $5,000 more per procedure without any obvious benefit, why is the da Vinci even an option?


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