The Future of Cancer and Robotic Assisted Surgery

Whether or not robotic assisted surgery is currently cost effective, the technology is here to stay. The industry has grown at an incredible rate making this technology more accessible across Canada, the United States and across the globe. For example, in 2004 less than 25,000 da Vinci surgical procedures were performed worldwide. In 2009, a mere 5 years later, there were close to 200,000 da Vinci surgical procedures. That is over a 45 percent growth .


As clinical trials are done, the da Vinci will hopefully improve in technology, accessibility, and how it is used. Clinical trials will pin point the draw backs of using the da Vinci Surgical System and provide ways in which the technology can be improved. Competition between medical institutions and hospitals to provide the most innovative procedures will increase demand for the da Vinci making its training programs more accessible to surgeons and its surgeries more available to patients, including those seeing cancer treatment. Surgical procedures will hopefully also be refined, as technological improvements will allow surgeons to perform more complex surgeries.

Just imagine what possibilities this technology could bring. With the growing speed and access to wireless networks, it is theoretically possible to use the da Vinci wirelessly over long distances. A surgeon from Vancouver could perform a da Vinci laparoscopic prostatectomy on a patient in Ottawa as long as the console (in Vancouver), and the patient side cart (in Ottawa) were connected via wireless technology. This could provide all different types of surgical opportunities as medical facilities would not necessarily need to have both the da Vinci console and patient side cart on site at the same time. This could also reduce the cost required to spend on da Vinci equipment, as hospitals may not need to invent in both the surgical console and the patient side cart.

There is really no way to know where this technology may eventually take us. But like most new technology, it is expensive and somewhat controversial. Should we continue to invest in this technology when there is a lack clinical research to show that it is cost effective? Who should be responsible for investing in this technology? Here in Canada, we are fortunate to have a universal health care system. But as taxpayers, should we be investing in technology that may not be cost effective? These are very tough questions to answer especially for hospitals, medical practitioners and policy makers.

As it stands right now, the da Vinci surgical system has the potential to provide several short term benefits for those undergoing minimally invasive surgery. This includes a number of cancer surgeries such as laparoscopic prostatectomy, laparoscopic hysterectomy and laparoscopic nephrectomy. Clinical research, all be it limited, seems to suggest that the da Vinci Surgical System can reduce blood loss and transfusion exposure during the procedure while reducing post-operative pain, recovery time and hospital stay when compared to typical laparoscopic and open surgical techniques. These advantages provide cancer patients with less invasive surgical options and alternatives to other suggested measures of treatment.

In time, as more clinical evidence is gathered, the da Vinci may offer more advantages as the technology is improved and as surgical procedures are refined. But until then, it remains a very expensive piece of technology with a tremendous amount of potential.

Robotic Assisted Surgery and Canada

As it stands right now, the da Vinci Surgical System is not as widely available in Canada as it is in other parts of the world. The following Canadian locations have access to the da Vinci Surgical System :

• St. Michael's Hospital (Toronto, ON)

• Toronto General Hospital (Toronto, ON)

• Sir Mortimer B. Davis - Jewish General Hospital (Montreal, QC)

• Hopital du Sacre-Coeur de Montreal (Montreal, QC)

• Montreal General Hospital (Montreal, QC)

• Vancouver General Hospital (Vancouver, BC)

• Royal Alexandra Hospital (Edmonton, AB)

• University of Alberta Hospital (Edmonton, AB)

• Rockyview General Hospital (Calgary, AB)

• St. Joseph's Hospital (London, ON)

• Canadian Surgical Technologies & Advanced Robotics (London, ON)