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There is no criticism of robotic surgery listed here, making the article read like a commercial or advertisement for da Vinci Surgical Systems. Criticism should be added. On possible reference:  —Preceding unsigned comment added by Brobdignagian (talk • contribs) 19:55, 14 February 2010 (UTC)
- couldn't agree more. this article is a sad excuse for what an encyclopedia entry should be. the mention of various 'prominent' practitioners reeks of commercial interest.Toyokuni3 (talk) 19:56, 23 June 2010 (UTC)
The reference to the unmanned surgery operation in Italy, May 2006 link is broken. Any chance theres another place with the article?
- I agree. It also appears that this is describing the same event as detailed in the preceding paragraph, thus I have removed the redundant, unverifiable line. --220.127.116.11 (talk) 19:05, 22 August 2009 (UTC)
The article on robotic prostatectomy is very one sided and sounds as if it was written by one of the companies acolytes. The advantages of robotic prostatectomy are few, the claims are unproven and the disadvantages are not mentioned. Few negative articles have appeared in the press. The New York Times (Feb. 14, 2010) featured an article titled “Results Unproven, Robotic Surgery Wins Converts” which begins to chronicle some of the concerns with it. Articles in medical journals by William J. Catalona, M.D. and Herbert Lapor, M.D., both internationally know prostate cancer experts have openly questioned the appropriateness of robotic prostatectomy. John P. Mulhall, M.D. has question the misinformation on websites about erectile function after robotic prostatectomies.
A brief review of some of the concerns with robotic prostatectomy is listed below:<br />
Complexity and difficulty of the procedure – the robotic tool is a very complex computer assisted mechanism. Mastering it is difficult with experts estimating the need to do 500 or more cases before one could be considered and expert. This is a very long learning curve compared to standard open surgery. In addition, it requires a very highly trained and specialized surgical team with technicians, more so than standard surgery, for its safe performance.
Bleeding and visibility – Bleeding must be controlled to the extreme with vigorous use of the electric diathermy cautery. What would be considered minor bleeding in any open surgery is unacceptable in robotic cases because vision via the camera lens can easily be obscured by blood splatter on the tiny aperture. The peri-prostate area is rich in vasculature. Significant bleeding from any medium sized vessel could necessitate the need to convert of an open case. An open hands-on access is undisputed as the best method to control hemorrhage. Comparing overall blood loss in standard open vs robotic approaches yields no clinically significant difference in typical cases when the surgeons are of equal skills since transfusions are rarely needed in either situation.
Minimally invasive? – The invasiveness of the surgey here applies only to the skin incision since the internal procedure is no different than a standard prostatectomy. A standard prostatectomy can be done with one 5 inch incision while a robotic case is performed through 5 one inch incisions.
Lymph Node dissection – A lymph node dissection is a standard component of oncologic surgery. It is always performed in the standard open procedure and the results of it can be instrumental in deciding appropriate adjuvant radiation therapy or not. A lymph node dissection is rarely done by most robotic surgeons because of the considerable increase in time of an already long case and the danger of injuring a major blood vessel such as the external iliac vein which would be almost impossible to repair robotically.
Loss of Surgical touch – A robotic surgeon has no tactile feel which is major disadvantage over standard open surgery. The surgeon’s hands provide an important added human sense to guide surgery and assess the organ for cancer, which can be felt but not seen.
Anesthetic – A standard open prostatectomy is commonly performed under just an epidural anesthetic while robotic surgery cannot and requires a full general anesthetic with intubation, ventilator and paralysis.
Time of Surgery – The length of the robotic procedure is generally twice that of an open case when comparing skin to skin and not just looking at robotic consol time. Any improvement in operative time in a robotic case requires a very experienced surgeon and surgical team.
Additional Risk Factors in Robotic Prostatectomy – Since many robotic surgeons use a transperitoneal approach, this opens the patient up to possible bowel injury during the surgery in addition to the risks during trocar insertion. Standard open prostatectomy is always performed in an extra-peritoneal retropubic approach. Carbon dioxide absorption during robotic surgery is an additional risk not present with standard open surgery. Rectal injuries which are rare (<1%) in open prostatectomies is reported to occur in up to 2.4% of robotic cases.
Urinary Incontinence – Studies have reported up to a 30% increase incidence of incontinence and a longer time to continence following robotic prostatectomy.
Erectile Dysfunction – Studies have reported up to a 40% increase incidence of erectile dysfunction following a robotic prostatectomy.
Oncologic Outcomes – no study to date has demonstrated any oncologic advantage for robotic prostatectomy. Cost – A study of the costs of a radical prostatectomy comparing the robotic vs an open approach reported the hospital loosing $4000 on every robotic case compared to earning $250 on a standard open case.
In conclusion, robotic prostatectomy might be considered a minimally invasive but maximally complex and expensive surgical procedure with no proven benefit to the patient other than a faster healing incision. — Preceding unsigned comment added by Drmacuol (talk • contribs) 22:10, 21 February 2011 (UTC)
Advantages and Disadvantages, the 3rd paragraph in this section is discussing a robotic mini CABG - one of the earliest procedures performed with the DaVinci, but its placement should be moved to a discussion of Cardiothoracic. It appears to be a leftover from an earlier version of this article. The article is very DaVinci heavy. True it is the only commercially available surgical robot currently available (2011) but it also has its own page.
— Preceding unsigned comment added by 18.104.22.168 (talk) 03:03, 18 July 2011 (UTC)
This article is on an important subject, but care needs to be taken with sources/links. Two of the links to external sites are broken (making some information unverifiable), and the third (to Integrated Surgical Systems, Inc) looks suspiciously like a spamlink; in addition, many statements in the article are unsupported. I have no doubt that they are true, and were added in good faith, but it is worth remembering that information that is unsourced can be challenged or removed by any editor at any time ;) Check out WP:VERIFY for more info - hope this helps! EyeSereneTALK 20:29, 25 May 2007 (UTC)
- I've added some more information about orthopedic surgical robots. The book reference added for the "CASPAR" system contains a good deal more information, also about the two other robots (Acrobot and Orthodoc); unfortunately, I don't have time to add it all. 22.214.171.124 (talk) 18:17, 21 August 2009 (UTC)
The reference to animal testing seems very out of place here and I'd like to nominate it for removal. Testing on animals is certainly not limited to robotic surgery and arguably the techniques of such surgery will be of great benefit to animals as well. (The entry on laparoscopy says that the first procedure on animals occurred more than 100 years ago, though obviously not with robots.) Without greater context, this section seems politically biased and unwarranted. —Preceding unsigned comment added by 126.96.36.199 (talk) 20:08, 3 October 2007 (UTC)
Right. Delete this. --Timekeeper77 06:47, 9 November 2007 (UTC)
Agreed. Journalist1983 14:44, 10 November 2007 (UTC)
AESOP and Zeus
this website seems not to have been updated since 5/00. and it is rather pov. it is a commercial site. the videos don't work. hell, for all i know the company may have failed. i think it should go.Toyokuni3 (talk) 15:45, 12 July 2008 (UTC)
- Done. Feel free to remove other sites yourself, as long as you record the reasons in the edit summery. --Jiuguang (talk) 16:00, 12 July 2008 (UTC)
AI Surgeon Robot
I'm not so sure about how valid this claim is in the history section. After reading a number of articles on robotic surgery I haven't come across any robots that are capable of autonomous operation. Furthermore I found this article which affirms that there was no autonomy involved in this particular operation. Also there is no citation for the statement about robots replacing surgeons. Remove? 188.8.131.52 (talk) 16:05, 25 April 2010 (UTC)
UC Santa Cruz
i just reverted an unexplained deletion of the link to this site by an unregistered user. now that i look at the site, it does look somewhat commercial. i am unsure of what to do and hope someone else has a better idea.Toyokuni3 (talk) 17:49, 29 April 2010 (UTC)
my attention was called to this item in the history section by someone tagging it for citation. what it really needed was to be gone. if there isn't a wp policy on talking about ongoing litigation, there ought to be. moreover, the writing style had newspaper written all over it, suggesting strongly that it had been lifted pretty much verbatim from a tampa paper. Toyokuni3 (talk) 12:48, 11 May 2010 (UTC)
- Check contents
- check refs
- check merge possibilty with other robotic medical
- reassess after work done
Timeline not correct
The fact, that before September 2010 there was no robotic system with force feedback is wrong. The Eindhoven University of Technology was not the first who invented this with the Sofie surgical system. I added the time when the MiroSurge was presented to the public, but I find it hard to just delete the line with the Sofie robot. What should I do? — Preceding unsigned comment added by 184.108.40.206 (talk) 16:04, 19 September 2011 (UTC)