Disadvantages to Robotic Surgery
Robotic surgery is a new technology, so its uses and efficacy have not been fully determined. Consequently, there are not many extensive long-term studies on the procedure to confirm or deny its effectiveness. There are, however, prominent disadvantages to robotics, including time, cost, efficiency, and compatibility with current systems.

(22.1)

Time

Robotic assisted heart surgery can take nearly twice the amount of time that a typical heart surgery takes, but this is variable depending on the surgeon's expertise and practice with the equipment.

In a longer surgery, the patient is under anesthesia for longer and it costs more to staff the procedure.

(22.2)

Cost

At this early stage in the technology, the robotic systems are very expensive. It is possible that with improvements in technology and more experience gained by surgeons the cost will fall. Others believe that with these improvements in technology the systems will become more complicated and the costs will rise. Another issue with costs is the problem with upgrading the systems as they improve. Only when these systems gain more widespread multidisciplinary use the costs will become more justified.

Efficiency and Compatibility

Another disadvantage is the large size of the system in an overcrowded-operating room. The robotic arms are awkward and bulky and there are many instruments needed in the small space. For robotic-assisted beating heart surgery, the space is even smaller because stabilizers are needed. For surgeons, this cramped area can interfere with their dexterity.

There are two possible suggestions for improving this problem, however both are costly. Some suggest miniaturizing the robotic arms and instruments while others believe that larger operating rooms are needed. With either solution, robotics is an especially expensive new technology.

Another disadvantage is that current operating room instruments and equipment are not necessarily compatible with the new robotic systems. Without the correct equipment, tableside assistance is needed to perform part of the surgery.

There are also concerns about using a static model for beating heart surgery and concerns about technical glitches that might occur during the surgery. (22.3) (22.4)

A standard cardiac robotic surgery set-up. Instruments entering the patient are contected to sterile robotic arms. Far in the back of the room, the surgeon sit operating the console. (22.5)

In Comparison to Standard Techniques

Dr. Michael Argenziano at New York Presbyterian Hospital said that on average, the robotic-assisted heart surgeries costs $2,000 more per operation, but in the end, the costs come out even because the patients recover sooner with the robotic procedure. He also noted that money was saved on nursing care and pain medications. (22.6)

With time and improvements in technology, these disadvantages will hopefully be remedied. If not, then it is possible that the advantages of these systems will not justify their cost.