judamd

I had laparoscopic surgery (not da Vinci) on July 15th and prior to
surgery I consulted with four surgeons before making a decision. Two
of these surgeons were at Stanford, one at Oakland Kaiser, and the
other in private practice. Two did only open surgery, the other two
did both lap and open surgery. When I asked about the da Vinci, all
of them independently said it was "OK" but that they thought it to be
a very expensive (million dollar) high tech device that did not result
in an improvement in outcome for the patients. They said the
physicians who use it either were new to removing prostates
laparoscopically and felt more comfortable with the robotic features
that aided them during surgery or that they were affiliated with a
facility that had a need to use the device in order to rationalize the
huge expenditure to the bean counters. Many doctors and hospitals
like to use it in their advertising to show the public that they are
at the "cutting edge" (pun intended). The private physician (who I
talked to last and who ultimately did my surgery) commented that his
first 40 lap procedures were with the da Vinci for the very reasons
stated above but that he now felt more comfortable not using the
device. All his subsequent lap surgeries (86 at the time I had my
procedure) were done without the da Vinci which now sits in its own
room at the hospital gathering dust. All agreed that no harm would
come to a patient with the da Vinci but none could see any advantage.
They did mention one drawback - it takes about an additional hour
under anesthetic to set the device up before actual removal of the
prostate begins so that the procedure takes about an hour longer with
it than without it, all else being equal.
Dave Perry