Authors' objectives:

This study aims to provide a bibliographic list of completed health technology assessments and relevant literature on robotic surgery.

Authors' results and conclusions: Seven HTAs, including six from INAHTA members and one from UHC, published through early 2002 with full text or summaries in English (summarized in Table 1). Updated bibliographic list of 59 citations published since 2001, which includes 54 studies reporting primary data from case series, one systematic review of telemedicine systems applied to the surgical field, and four descriptive articles about subjects related to robotic surgery (eg. clinical privileging).

Authors' recommendations: Interest in robotic surgery, and in particular telesurgical robotics, is growing due to its potential to generate profit, to improve access to care, surgical procedures and patient outcomes, and to reduce the cost of care. These technologies are marketed with FDA 510(K) premarket approval for a fairly restricted array of indications. Evidence from health technology assessments to date confirms that robotic surgery technologies are emerging technologies for which limited data from heterogeneous case series show them to be safe and feasible for a range of minimally invasive procedures. However, their clinical use is limited by: high initial investment and operating costs; substantial training requirements; and lack of strong evidence from well-designed clinical trials from which to determine effectiveness and cost-effectiveness relative to current practices. It is also unclear how the introduction of these technologies will impact the overall design and work processes in the operating theater, or how the corporate merger of the two major telesurgical producers in the US will affect the cost and availability of their devices. Diffusion of the technologies is taking place primarily to fulfill research and education missions or to enhance prestige and profit, and likely will continue to increase as the technology evolves and both effectiveness and cost-effectiveness are demonstrated.

Authors' methods: Bibliography

Project Status: Completed

URL for project: http://www4.va.gov/VATAP/docs/RoboticSurgery2006ttm.pdf

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: VA Technology Assessment Program

Contact Address: Liz Adams, VA Technology Assessment Program, Office of Patient Care Services (11T), VA Boston Healthcare System Room 4D-142, 150 South Huntington Avenue, Boston, MA 02130 USA Tel: +1 617 278 4469; Fax: +1 617 264 6587;

Contact Name: elizabeth.adams@med.va.gov

Contact Email: elizabeth.adams@med.va.gov

Copyright: Technology Assessment Unit, Office of Patient Care Services, US Department of Veterans Affairs (VATAP)