Robot arms race feared in N.Y.

A New York state Department of Health planning committee scrutinized a "proliferation of robots" during its recent months-long review of the state's certificate of need process, saying too many hospitals are preoccupied with buying high-tech, high-cost equipment regardless of need.

The committee voted to approve a draft report of CON reforms last month.

Multiple hospitals in a region have been buying $1.5 million surgical instrument packages—despite the low likelihood that there are enough potential patients to keep even one facility's robot busy.

Some members raised concerns about safety, given the learning curve surgeons experience before they can use the complex machines properly. Cost is also a consideration. The disposable items involved in a typical procedure can tally between $1,000 and $1,500.

Robotic surgery has become the standard of care for some procedures, such as a prostatectomy.

"There is lower mortality and lower incidence of incontinence" when surgeons use the robotic device, said Myriam Curet, chief medical adviser at Intuitive Surgical, the California company that makes the DaVinci robotic equipment.

Although the disposable items involved are expensive, she said the cost is worth it when faster patient recovery times and other benefits are taken into account. If New York state requires a certificate of need for the purchase of the devices, the CON process would be something "not done in other states," she added.



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