Innovations in surgical tools are important, but a new study suggests more time be spent on learning how to use the technology before its transition to the operating room. Researchers at the University of California, San Diego School of Medicine found an unsettling link between increased use of new surgery equipment and a higher risk of patient harm.
In the study, which was published in the online journal JAMA Surgery, researchers from USD found that the risk of patient harm began to double after doctors began to embrace the use of minimally invasive robotic surgery for prostate cancer. The main surgery in the researchers' study was robotic-assisted laparoscopic prostatectomy. This involved an operation on the prostate gland and/or the surrounding seminal vesicles. The surgical robotic arms involved in these operations were found to sometimes “lead to adverse events for patients,” Kellogg Parsons, first author of the paper, explained in a press release.
The Tools Aren’t Bad
The number of minimally invasive robotic prostatectomies has drastically increased since their introduction in the early 2000s. In the year 2003, there were an estimated 617 operations of this category performed, and by 2009 this number rose to 97,753. The problem does not exactly lie in the increased use of this new technology. Christopher Kane, a professor of surgery and intermin chair of the Department of Surgery, UC San Diego, explained in the press release how robotic prostatectomy has been proven to be beneficial to the patient with less health risks than traditional surgical options when administered by experienced surgeons.
People Just Need To Use Them Better
The increase in injuries tied to this instrument’s use, however, is a major cause for concern. In 2005, an individual was twice as likely to have unpleasant side effects following this surgery, and in 2006 the number exceeded over 10 percent of cases. Kellogg believes that these injuries are due to an insufficient testing period, a trend which he describes as "not new to robotic surgery." The fault does not lie in the technology but in those using it without proper preparation. "A responsibility of deploying a surgical technology should include the responsibility to monitor it as it diffuses throughout the real world to ensure safety," said David Chang, senior author of the study.
That's A Lot Of Practice!
In order to best avoid further harm caused by these surgical tools, “development of standardized training and credentialing programs,” could be enacted, Parsons said. Although the idea of undergoing minimally invasive robotic prostatectomies implies that artificial intelligence is performing the surgery, in reality the doctor still does need to learn new skills in order to treat patients well. Surgeons may need to perform as many as 1,500 of these robotic assisted surgeries before they are able to reach optimal results.
Source: Kellogg Parsons J, Messer K, Palazzi K, Stroup S, Chang D. Diffusion of Surgical Innovations, Patient Safety, and Minimally Invasive Radical Prostatectomy. JAMA Surgery. 2014.