Wed | Sep 26, 2018

Robotic surgery - the wave of the future? Maybe not

Published:Tuesday | October 14, 2014 | 12:00 AM
The entrance to the Tony Thwaites Wing at the University Hospital of the West Indies.

ARE YOU ready to replace your surgeon with a robot? At least one Jamaican doctor has stated that a few of his patients have opted for robotic surgery offered in North America because of the intense marketing offered by such facilities. Robotic surgery has been on the market since 2009, and these Jamaican patients return to facilities like the Tony Thwaites Wing at the University Hospital of the West Indies to recover from operations done overseas.

Dr William Aiken, urologist attached to the Tony Thwaites Wing, stated: "We lose a lot of patients each year to North America because they (patients) want a robotic procedure. It is absolutely for the hype, and the demand locally for robotic surgery is very, very high. Although there are a lot of downsides, these are not highlighted in the medical-marketing brochures. However, if you watch TV, you will notice a number of lawyers advertising for persons who have had robotic procedures done, and have since experienced complications. Nevertheless, we do lose a lot of patients in the private sector who go to North America for robotic surgery of one type or another."

Dr Clarence McGraw, an anaesthesiologist also attached to the Tony Thwaites Wing, noted that surgeons who are good at video games tend to gravitate towards robotic surgical techniques. According to research on the subject, Jamaicans who travel abroad for this type of surgery can choose from remote surgery, minimally invasive surgery and unmanned surgery. The attraction to robotics is that the surgery is done with precision, miniaturisation, smaller incisions, decreased blood loss, less pain, and quicker healing time.

Negative results

However, Dr Aiken notes: "What is interesting is that sometimes those patients come back with worse outcomes than if they had stayed, and so it's not about getting a robotic procedure. It's about who does it, and so I tell my patients, 'If you're going abroad to get a robotic operation, go to a surgeon who has done a lot of these type of procedures'."

Given that there is the demand for robotic surgery in Jamaica, why hasn't the medical community met the demand? Dr Aiken explained: "I was looking at an article of research recently. A surgical robot costs US$2 million, and the maintenance and disposable costs are quite alarmingly high. You have to do at least 300 procedures a year just for it to be economically viable, and then that doesn't factor in the maintenance and the upkeep and having an engineer available. So you have to wonder, is this the way that Jamaica should go?"

Jamaican surgeons have focused on minimally invasive techniques done by humans, which reduces recovery time. "I have witnessed that shift first-hand over the last 20 years," Dr Aiken said. "For example, most patients with kidney stones, say 20 years ago, were treated via an open procedure. Nowadays, I would say the vast majority of Jamaican patients, or certainly patients accessing the urology clinic at the tertiary institutions, would be able to have a minimum invasive technique."