Hospitals mislead patients about robotic surgery

Robotic surgery is often touted as the latest and greatest breakthrough in medical technology, but a new study suggests that many hospitals in the United States mislead patients about its benefits. Johns Hopkins researchers found that 40% of hospital Web sites promote robot-assisted surgery, even though little evidence shows it’s better than conventional methods.

The study, published in the Journal for Health Care Quality, evaluated 400 randomly selected hospital Web sites. Researchers looked at the placement of information about robot-assisted surgery on the sites, claims about its risks and benefits, and the use of images or text provided by the robot’s manufacturer.

About two in five of the Web sites described the availability and mechanics of robotic surgery. Of these, 37% mentioned robot-assisted surgery on the home page and 66% cited information about the procedure within one click of the home page. Nearly three-quarters of the sites used industry-provided marketing materials or linked to the manufacturer’s Web site. When describing robotic surgery, nearly all of the hospital Web sites claimed clinical superiority to other surgical methods; one-third also reported improved cancer control. None of the sites noted any risks.

The number of patients undergoing robot-assisted surgery has grown 400% over the last four years. Advocates say that robotic procedures result in less pain, smaller incisions, and shorter hospital stays, but these claims are anecdotal. Currently, no long-term studies have been published that demonstrate any benefits.

Dr. Marty Makary, the study’s leader, questions how hospitals arrived at their claims about the robot’s benefits and voices concern about potential conflict-of-interest, given that robotic procedures typically cost more than traditional ones.

“The public regards a hospital’s official Web site as an authoritative source of medical information,” he said in a statement issued by Johns Hopkins. “Hospitals need to be more conscientious of their role as trusted medical advisers and ensure that information provided on their Web sites represents the best available evidence.”

Another study, presented at the American Urological Association’s annual meeting in May 2011, found that the number of prostatectomies performed between 2005 and 2008 increased by nearly 50%—even though the incidence of prostate cancer has declined. That dramatic change coincided with the introduction of robot-assisted procedures. In fact, robot-assisted surgery accounted for 15% of all prostatectomies in 2004, but more than 80% of them in 2008, implying that hospitals’ marketing efforts are working.

Sources: Jin LX, Ibrahim AM, Newman NA, et al. Robotic Surgery Claims on United States Hospital Websites. Journal for Healthcare Quality 2011. [E-publication.]

Lavery HJ, et al. Not a Zero-Sum Game: The Widespread Adoption of Robotics Has Increased Prostatectomy Utilization in the United States. American Urological Association 2011 Annual Meeting; abstract 76.

Published June 10, 2011.