by darkspilver 14 Replies latest watchtower medical
OC...
I was saying that the data against the procedure is flawed. Comparing apples to oranges... It seems one sided, the Government using one study vs the doctors saying they support the procedure, and people even paying for the extra costs...
I will go where the data leads, but then the urologists or scientists or whoever makes the data, should come up with a good study which decisively shows benefits or drawbacks either way...
That was my point.
Okay, ILove. Sorry if I misunderstood. The issue was like you said, evidence.
Solid data and evidence is needed. Especially when public $$$ is being used.
What I find interesting about the OP is that this is yet another media piece that uses a Jehovah's Witness patient to promote and/or discuss medical technology. A patient who doesn't even have a medical blood disorder - they have a blood disorder that has been given to them. And that is the selling point - no blood. From a made up blood disorder.
I went the robot, at a leading cancer center "City of Hope" LA Ca.
The blood issue is no major issue in this type of sugary.
Incontinence is the major issue, how much the plumbing leaks after operation. The robot is very precise, using magnification, air pressure to create space for minimal amount of tissue to be cut. The movements are very controlled through what ever setting the operator sets. A major determining factor of sugary success lies in the patient and how serious he takes his pelvic floor exercises.
This is just personal opinion. A surgeon told me sugary is one half science, one half art. A highly skilled surgeon is just that. The robot can take a good surgeon and make him competitive with a higher skilled surgeon. Sugary has three factors 1; how healthy we have maintained our body, 2; skill of surgeon, 3; how serious we do our rehab. Personally for me the robot was a much wiser decision then the Urologist I knew from the gym.
FYI below is a link to the full 172 page report
http://www.hqontario.ca/Portals/0/Documents/evidence/reports/hta-prostatectomy-1707-en.pdf
Health Quality Ontario - Ontario Health Technology Assessment Series
Robotic Surgical System for Radical Prostatectomy: A Health Technology Assessment
KEY MESSAGES
Prostate cancer is the second most common cancer in men in Canada. It forms in the prostate gland of the male reproductive system and often grows very slowly. However, in some patients, prostate cancer grows more quickly and is fatal.
One of the possible treatments for prostate cancer is to surgically remove the prostate gland. This is known as radical prostatectomy. It can be performed in an open, laparoscopic, or robot-assisted approach. The open approach is the traditional surgical approach and involves a large incision. In contrast, laparoscopic and robot-assisted approaches are minimally invasive and performed through small keyhole incisions. The robot-assisted approach is the newest method. It uses a surgical robotic system with arms that the surgeon controls to perform the radical prostatectomy.
We reviewed the evidence to evaluate the effectiveness, safety, and cost-effectiveness of the robotic surgical system for radical prostatectomy compared with the open and laparoscopic approaches.
We did not find high-quality evidence that the robot-assisted approach improves cancer-related outcomes or important functional outcomes (e.g., urinary function and sexual function). The robotic surgical approach does appear to improve some perioperative outcomes, such as the length of the hospital stay and blood loss.
Patients may prefer the robot-assisted method, particularly if their surgeon recommends it as a better treatment.
Our economic analysis showed that compared with open radical prostatectomy, the costs of using the robotic system are relatively large while the health benefits are relatively small. Thus, robot-assisted radical prostatectomy does not appear to be cost-effective in Ontario.
http://www.hqontario.ca/Portals/0/Documents/evidence/reports/hta-prostatectomy-1707-en.pdf
Now it's happening in the UK.....
Robotic-Assisted Surgery - Balancing Evidence and Implementation
Journal of the American Medical Association, Tuesday, October 24, 2017
READ FULL ARTICLE: https://jamanetwork.com/journals/jama/article-abstract/2658297
High cost of robot surgery not justified
The Times, Wednesday, October 25, 2017
Patients having robotic cancer surgery do no better than those undergoing conventional keyhole operations.
Doctors have said that companies must either improve the technique or cut the cost because the NHS cannot afford to spend money for little benefit.
The growth of robotic surgery has been largely driven by marketing in the US rather than clinical evidence, researchers say in the Journal of the American Medical Association.
The NHS has 58 surgical robots, which cost more than £1 million each, adding about £1,000 to the cost of each operation. “Surgical technology just seems to creep its way in to clinical practice,” said David Jayne, of St James’s University Hospital in Leeds. “The big thing about robot surgery is it’s dramatically expensive. The NHS was forking out millions of pounds and we had no idea if there was any benefit.”
His trial of 471 patients having rectal cancer surgery found no significant evidence the robots made procedures easier to do. Complication and death rates were the same as for keyhole surgery.
A Stanford study of 24,000 patients found that robot-assisted operations for kidney cancer took longer and there was no difference in complication rates.
READ FULL ARTICLE: https://www.thetimes.co.uk/edition/news/high-cost-of-robot-surgery-not-justified-380ltvlhq
