Robotic Surgery and the Low End of the Learning Curve

Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters.


Austin Frakt points us today to a new study that compares the effectiveness of robotically assisted hysterectomies vs. laparoscopic surgery. “Both approaches provide benefits compared with open surgery,” says an editorial in JAMA, “including smaller incisions, shorter hospital stays, less postoperative pain, and possibly quicker return to function.” But the robotically-assisted surgery costs more without providing any improvement in outcomes. “On these results alone,” says Austin, “the call is a simple one. At current prices and on the basis of health outcomes, robotic hysterectomies are not worth the cost.”

Normally, I’d be jumping up and down to agree. But this time, I think there’s reason to pause. Why? Because of this from the JAMA editorial:

Robotic surgery may have a shorter learning curve than laparoscopic surgery, making it an enabling technology that allows surgeons otherwise unable to perform minimally invasive surgery to offer this benefit to their patients.

This is the future of surgery, and I suspect there may be a real benefit to rolling it out widely, getting lots of surgeons trained to use it, and producing commercial pressure to constantly improve the technology. I’m not trying to make excuses for rosy advertising promises or hospitals that hype their results to push patients into a more expensive procedure, but at the same time, this strikes me as qualitatively different from, say, billion-dollar proton beam facilities to treat cancer. In the long run, robotic surgery is likely to make medicine cheaper, safer, and more widely available worldwide, and the sooner we get to this future, the better off we are. A bit of a gold-rush mentality while we’re still at the low end of the learning curve might be the price we pay for this.

I have a feeling my point is going to be misunderstood here. I also have a feeling it’s hopeless to add a whole string of caveats. Just try to take this in the spirit in which it’s offered, OK?

AN IMPORTANT UPDATE

We’re falling behind our online fundraising goals and we can’t sustain coming up short on donations month after month. Perhaps you’ve heard? It is impossibly hard in the news business right now, with layoffs intensifying and fancy new startups and funding going kaput.

The crisis facing journalism and democracy isn’t going away anytime soon. And neither is Mother Jones, our readers, or our unique way of doing in-depth reporting that exists to bring about change.

Which is exactly why, despite the challenges we face, we just took a big gulp and joined forces with the Center for Investigative Reporting, a team of ace journalists who create the amazing podcast and public radio show Reveal.

If you can part with even just a few bucks, please help us pick up the pace of donations. We simply can’t afford to keep falling behind on our fundraising targets month after month.

Editor-in-Chief Clara Jeffery said it well to our team recently, and that team 100 percent includes readers like you who make it all possible: “This is a year to prove that we can pull off this merger, grow our audiences and impact, attract more funding and keep growing. More broadly, it’s a year when the very future of both journalism and democracy is on the line. We have to go for every important story, every reader/listener/viewer, and leave it all on the field. I’m very proud of all the hard work that’s gotten us to this moment, and confident that we can meet it.”

Let’s do this. If you can right now, please support Mother Jones and investigative journalism with an urgently needed donation today.

payment methods

AN IMPORTANT UPDATE

We’re falling behind our online fundraising goals and we can’t sustain coming up short on donations month after month. Perhaps you’ve heard? It is impossibly hard in the news business right now, with layoffs intensifying and fancy new startups and funding going kaput.

The crisis facing journalism and democracy isn’t going away anytime soon. And neither is Mother Jones, our readers, or our unique way of doing in-depth reporting that exists to bring about change.

Which is exactly why, despite the challenges we face, we just took a big gulp and joined forces with the Center for Investigative Reporting, a team of ace journalists who create the amazing podcast and public radio show Reveal.

If you can part with even just a few bucks, please help us pick up the pace of donations. We simply can’t afford to keep falling behind on our fundraising targets month after month.

Editor-in-Chief Clara Jeffery said it well to our team recently, and that team 100 percent includes readers like you who make it all possible: “This is a year to prove that we can pull off this merger, grow our audiences and impact, attract more funding and keep growing. More broadly, it’s a year when the very future of both journalism and democracy is on the line. We have to go for every important story, every reader/listener/viewer, and leave it all on the field. I’m very proud of all the hard work that’s gotten us to this moment, and confident that we can meet it.”

Let’s do this. If you can right now, please support Mother Jones and investigative journalism with an urgently needed donation today.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate