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Hospitals Hype Robot Surgery for Women: Study

Consumers shouldn't expect straight talk about robot surgery from hospital  websites, but rather vague claims and marketing mantras, according to a new U.S.  study.

Researchers sifted through online information from 432 hospitals across the  country and found nearly half marketed robotic surgery for gynecologic  conditions such as endometriosis or cervical cancer.

A quarter of those hospitals used boilerplate copy from the robot  manufacturer Intuitive Surgical, and one in six told consumers that "you owe it  to yourself."

However, almost none mentioned potential downsides to the technology such as  increased operating time or higher cost compared with conventional types of  surgery.

"This is marketing," said Dr. Jason Wright, a gynecologic surgeon at Columbia  University in New York, who led the new work. "Many of the claims that were made  by hospitals were not supported by high-quality data."

Robot surgery originally took off as a new way to operate on men with  prostate cancer, but doctors have since started using it for several other  procedures, too. Today, the technology is being used in hundreds of thousands of  surgeries every year.

According to California-based Intuitive Surgical, more than 2,200 of its da  Vinci robots have been installed worldwide. The machines, which are operated by  a surgeon, run between $1 million and $2.5 million each.

Compared with open surgery, in which the doctor makes one long incision,  robot surgery leads to a faster recovery and less blood loss, said Wright. But  it's not clear that it has any advantages over traditional minimally invasive  surgery, called laparoscopy, he added.

"There is definitely a role for robotic surgery and I think it is an exciting  technology," said Wright, who uses the technology himself. "But right now the  data are really very limited."

WHAT RISKS?

Wright's team found that most hospitals described robot surgery as having  several benefits, but just 15 percent referenced data from clinical trials to  support those claims.

And only a few hospitals discussed the risks, operating time and price, which  is usually at least $1,000 higher than for traditional laparoscopy.

The findings, published in the American Journal of Obstetrics &  Gynecology, jibe with a report from last year that looked at how U.S. hospitals  describe robot surgery in general on their websites.

That study, in the Journal for Healthcare Quality, concluded that online  materials "overestimate benefits, largely ignore risks and are strongly  influenced by the manufacturer."

In a quick Web search, Reuters Health found several hospitals advertising  "better clinical outcomes" with robot surgery. Yet none of them made clear what  those outcomes were or what treatment the comparison group got.

The Nebraska Medical Center in Omaha is a case in point. From its homepage,  it takes just two clicks to get to a video touting robotic surgery for  gynecologic cancer.

"This is all brand new, it's phenomenal, it's changed how we practice  medicine," Dr. Kerry Rodabaugh exclaims as the video begins.

Four minutes later, without having mentioned any risks, she ends the piece by  saying, "It's really wonderful to be able to give this option to patients,  because it's just plain better."

Rodabaugh did not return phone calls requesting comments; nor did the  marketing directors of two other hospitals, St. Anthony's Medical Center in St.  Louis and the University of Missouri Health Care in Columbia, both of which  advertise robot surgery on their websites.

Wright acknowledged that many hospitals are businesses and have the right to  market their services. But at the same time, patients trust hospitals to provide  more-balanced information than manufacturers, he said.

"Most patients have a higher expectation of physicians and hospitals," Wright  told Reuters Health. "Hospitals should have a mandate to supply unbiased  information to patients."

In the meantime, he added, people should quiz their doctor about the risks  and benefits of the procedure they are considering and ask about the scientific  evidence for those claims.

The study was published online in American Journal of Obstetrics & Gynecology, July 2,  2012

Source: Medical Daily at  http://www.medicaldaily.com/articles/10993/20120720/robot-surgery-hype-women.htm#RbipIw3H77IHU4Tg.99

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