Authors' objectives:

This report will update VATAP's previous bibliography report on robotic surgery produced in 2004 (VATAP 2004). As before, it will consider only robotic surgical devices that have received FDA approval. It will also consider all available indications for use of robotic-assisted surgery compared with existing surgical procedures.

Authors' recommendations: Recommendations to the TAAG: While the evidence does not confer clear advantages to using robotically-assisted surgical procedures, there may be other compelling reasons to further evaluate certain applications for use in VA, for example, the prevalence of disease or condition or the ability to address staffing shortages in the surgical theater in a safe and cost-effective manner. With that in mind, the robotically-assisted laparoscopic applications with the best available evidence for prevalent health conditions in VA that may offer safe and cost-effective alternatives to current practices are: 1. Radical prostatectomy=although the evidence base consists of non-experimental studies, this application has been the most widely studied to date. There is significant media and professional interest in this procedure. 2. Nissen fundoplication=the evidence from two independent, experimental studies shows comparable feasibility and safety of robotically-assisted Nissen fundoplication to the standard procedure, but the investigators tempered their conclusions due to the high costs and longer operating times. 3. Cholecystectomy=the evidence from two independent, experimental studies suggests comparable feasibility and efficacy of the robotically-assisted procedure using the Zeus/AESOP system to the standard procedure. The robotically-assisted procedure has some technical advantages but also takes longer. Using the Zeus/AESOP system would require additional investment and training, since the other procedures use the daVinci system.

Authors' methods: Bibliography

Project Status: Completed

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

Year Published: 2006

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)