Robot surgery faces legal hurdles

Posted by Nick Farrell

The future of robot surgery is becoming mired because the US legal system cannot work out who can be sued if something goes wrong or if doctors are getting enough training on the gear.

More than 2,500 da Vinci robots are at work in world hospitals and generally their work means less blood loss, smaller scars and quicker recovery time.

But there have been a few accidents. In 2007, surgeons in Aalst, Belgium, had a surgical robot's arm broke off inside a patient with prostate cancer. The instrument was so badly bent it could not be removed through the original keyhole incision.

The firm that makes da Vinci, Intuitive Surgical, has attracted the attention of the US Food and Drug Administration (FDA) which is asking surgeons about the system.

There are 10 product liability lawsuits that have been filed against da Vinci's makers in the past 14 months.

The FDA wants to find out if the rise in reports is a true reflection of problems, or simply an increase due to other factors.

And this is the problem. If the robot is breaking, you sue Intuitive Surgical, if the problem is caused by a badly trained surgeon, you sue the hospital, if it is dodgy doctors playing with a patient like they are a computer game you sue them.

This question appears to be overtaking the more important fact that the robot aims to offer minimally invasive, highly accurate surgery with a human in control at all times.

The technology allows a surgeon to handle the instruments on the robot's four arms from a console with a stereoscopic 3D view of the operation, magnified up to ten times.

But if the surgeon is not using the robot correctly, how does the insurance company prove that? If they sue the company, then that is hardly fair if the surgeon cocked up.

James Breeden, president of the American Congress of Obstetricians and Gynecologists told New Scientist that studies show there is a learning curve with new surgical technologies, during which there is an increased complication rate. Some surgeons only get two days' training on da Vinci.