tag:blogger.com,1999:blog-2760353953251845523.post8580138255734835605..comments2024-02-10T02:14:39.898-05:00Comments on Buckeye Surgeon: The Cost of InnovationJeffrey Parks MD FACShttp://www.blogger.com/profile/15650563299849196122noreply@blogger.comBlogger5125tag:blogger.com,1999:blog-2760353953251845523.post-47169732812057187632009-08-20T23:52:25.589-04:002009-08-20T23:52:25.589-04:00Couldn't agree more. I am a gynecologist (15 ...Couldn't agree more. I am a gynecologist (15 yrs out of residency) now asked to learn robotic surgery.<br /><br />I know of no reputable non-proprietary study that shows significantly improved results with robotic surgery, yet we are inundated with patient requests for it due presumably to an active marketing campaign by the manufacturer of the robot. <br /><br />A recent CNN story shows a guy riding a bike who says he wanted this type of prostatectomy, which costs more than double the standard surgery, because he wanted to ride his bike a couple weeks earlier! <br /><br />Now, maybe two weeks of bike riding is worth $10,000, but we should at least pause and stop wondering why health care costs are rising so dramatically. In the CNN story, the quote by the urologist at the University of Kansas: "no evidence that robotic surgery is better." I guess the Intuitive Surgical, Inc. marketing representative hasn't taken him out to dinner yet!Tonyhttps://www.blogger.com/profile/03056377038486402824noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-89729843941381836602009-08-12T09:23:34.360-04:002009-08-12T09:23:34.360-04:00Of course no one probably imagined the varied uses...Of course no one probably imagined the varied uses that a good surgeon can do with 3 lap incisions on the belly when it was first invented. All major changes start somewhere and while I agree that converting lap choles to nonincision choles are probably not going to make a real difference robot guided vessel repairs, lymph node dissections, etc. all hold a lot of promise for improvementGuiacnoreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-73385713502838837052009-07-29T23:40:52.353-04:002009-07-29T23:40:52.353-04:00i think Single Incision Lap Surgery (SILS) should ...i think Single Incision Lap Surgery (SILS) should instead be the way to go. The incision is neatly hidden at the umbilicus and you achieve greater visualisation and control during the operation.Jeffreyhttps://www.blogger.com/profile/06540388790434163301noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-12911221492241452322009-07-29T05:59:35.441-04:002009-07-29T05:59:35.441-04:00The robotic surgery is not without its own problem...The robotic surgery is not without its own problems - especially in patients who have underlying comorbidities and cannot tolerate the extremem trendelenberg required. Have seen a patient arrest from the strain placed on their heart and a trip to the ICU followed. I'm not sold on the robotic surgery, but we have a residency program in my institution that does almost all of a particular surgery with this. It doesn't seem to make much difference and, like noted above, can actually be more problematic because of positioning requirements.Resident Anesthesiologist Guy (RAG)https://www.blogger.com/profile/02279676329474145951noreply@blogger.comtag:blogger.com,1999:blog-2760353953251845523.post-36131373564692101702009-07-28T22:47:23.005-04:002009-07-28T22:47:23.005-04:00Predictably Irrational (Arieley) has an interestin...Predictably Irrational (<a href="http://www.predictablyirrational.com/" rel="nofollow">Arieley</a>) has an interesting section that talks about how "market value" comes about: through comparison and "in the eye of the beholder."<br /><br />If we keep on seeing health care as a "market," precisely as industries see it, it would be very unlikely for us to escape such fallacy.Anonymousnoreply@blogger.com