Hospitals mislead patients about robotic surgery

Posted by Kate Taylor

Large numbers of US hospitals are misleading patients about the so-called benefits of robotic surgery, with many making wholesale use of material provided by manufacturers.

A team at Johns Hopkins University found that around four in 10 hospital websites publicize the use of robotic surgery, with most touting its clinical superiority - despite a lack of scientific evidence that it's any better than conventional operations.

They tend to overestimate the benefits of surgical robots and largely ignore the risks, and are strongly influenced by the product's manufacturer.

"The public regards a hospital's official website as an authoritative source of medical information in the voice of a physician," says Marty Makary,an associate professor of surgery at the University's School of Medicine.

"But in this case, hospitals have outsourced patient education content to the device manufacturer, allowing industry to make claims that are unsubstantiated by the literature. It's dishonest and it's misleading."

In the last four years, the use of robotics forminimally invasive gynecological, heart and prostate surgeries and other common procedures has grown four-fold. Proponents say it leads to smaller incisions, is more precise and results in less pain and shorter hospital stays.

But, says Makary, these claims are unsubstantiated. There are no randomized, controlled studies showing any benefit to patients. Robotic surgeries take more time, keep patients under anesthesia longer and are more costly, he says.

Not that you'd know it from reading most hospital websites, he says. For example, a third say that the technique yields better cancer outcomes — a notion that Makary says is misleading to a vulnerable cancer population seeking out the best care.

Forty-one percent of the 400 hospital websites reviewed described the availability and mechanics of robotic surgery, the study found. Of these, 37 percent presented the information on the homepage and 66 percent mentioned it within one click of the homepage. Manufacturer-provided materials were used on 73 percent of websites, while 33 percent directly linked to a manufacturer website.

When describing robotic surgery, the researchers found that 89 percent made a statement of clinical superiority over more conventional surgeries, the most common being less pain (85 percent), shorter recovery (86 percent), less scarring (80 percent) and less blood loss (78 percent). Thirty-two percent made a statement of improved cancer outcome. None mentioned any risks.

"This is a really scary trend," Makary says. "We're allowing industry to speak on behalf of hospitals and make unsubstantiated claims."