Diagnostic Center for Disease: Robotic Prostatectomy - A Race t... (e and permanent erectiledysfunction. ...)

Diagnostic Center for Disease: Robotic Prostatectomy - A Race to Failure?

Date:6/24/2008

e and permanent erectile dysfunction.

Robotic surgical technology and the procedure is still fairly new. There is as yet nothing dramatically different in performing the procedure or the results compared to traditional laparoscopic surgery. However, armed with hope for improved results, the urology community has increased the rate of these surgeries, and their search for cancer at alarming rates. In 2000, there were 1500 robotic prostatectomies performed. Last year, 2007, it is estimated that 50,000 robotic prostatectomies were performed.(1) The rate of procedures is still climbing, with projected 80,000 or more robotic prostatectomy procedures in 2008. The number is staggering when you add robotic surgeries to all other curative procedures performed which include open prostatectomy, conventional laparoscopic prostatectomy, radiation in all forms, radiation seed implantation, cryosurgery, thermometry, focused ultrasound ablation, etc. The significant cost of the robotic system may be driving the search for new cancers in addition to an increase in the number of surgeries. A typical robotic surgery device costs $1.2M with annual maintenance of approximately $120,000.00 per year.(2) In spite of the popularity of this procedure, robotic prostatectomy has yet to deliver any results or evidence that it will provide any improvement over other treatments to cure prostate cancer.

A great number of urologists and academic centers promote early detection and early curative treatment, citing a better cure rate.

"These technical improvements would lead one to believe that improved

results with continence, potency and oncologic outcomes should logically

follow. Ultimately, long-term outcomes and possibly financial impact will

determine the role of robotic-assisted laparoscopic prostatectomy.(1)"

Published results of several studies simply do not support this supposition:

"Cancer cure rate, measured by presence of cancerous
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