Researchers at the University of California, San Diego School of Medicine have found that the risk of patient harm increased two-fold in 2006 the peak year that teaching hospitals nationwide embraced the pursuit of minimally invasive robotic surgery for prostate cancer. Results of the study are published in the July 2 online issue of JAMA Surgery.
"This study looked at the stages of innovation and how the rapid adoption of a new surgical technologyin this case, a surgical robotic systemcan lead to adverse events for patients," said Kellogg Parsons, MD, MHS, surgical oncologist, UC San Diego Health System and first author of the paper. "There is a real need for standardized training programs, rules governing surgeon competence and credentialing, and guidelines for hospital privileging when novel technologies reach the operating rooms of teaching and community hospitals."
In 2003, there were an estimated 617 minimally invasive robotic prostatectomies (MIRPs) performed in the United States. By 2009, this number increased to 37,753 procedures. In 2005, patients were twice as likely to experience an adverse event if they were undergoing MIRPs compared to a traditional open surgical procedure. The following year � was considered the tipping point for the adoption of MIRP when it equaled or exceeded 10 percent of all cases.
"The trend observed here is not new to robotic surgery. The same phenomena occurred with the move to minimally invasive approaches to gallbladder and kidney surgeries, both surgeries that are now well documented to improve safety and outcomes," said Christopher Kane, MD, professor of surgery and interim chair of the Department of Surgery, UC San Diego School of Medicine, who was not involved with the study. "Whenever a new technology is adopted there is a temporary period where there may be an increased risk to the patient. This can be reduced by extensive surgical training, vigorous credentialing
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University of California - San Diego