In August 2014 the Royal Derby hospital, where I have a practice, installed a Da Vinci Robotic surgery system. It’s considerable acquisition and running costs were funded by a generous private benefactor. There is no doubt that this is a marvel of modern medical technology. It allows a surgeon to carry out minimally invasive procedures with major benefits to the patient of significantly less pain, a shorter hospital stay and faster rehabilitation.
From the surgeon’s point of view it offers greater surgical precision, increased range of motion, improved dexterity and improved access when compared with traditional Laparoscopic (Keyhole) surgery. I have carried out procedures using this system myself and the results are impressive.
There is though a conflict that this kind of progress presents to our healthcare system. There is no doubt that this equipment can make a surgeon’s job more effective with the promise of better outcomes for patients. It is also much more ergonomic than traditional open or laparoscopic surgery thus resulting in less fatigue for the operating surgeon. When the capital cost of “the robot” along with its maintenance contract and the cost of disposable items required is factored in it is much more expensive than traditional surgery
More expensive technology means more expensive procedures for which money has to come from budgets already under intense pressure. It is difficult to envisage us retreating from this progress but equally we have to accept that the funding for the NHS is finite. This is a very good example of how, in my view, the cost of treatment is increasing at a rate far greater than the current model for the NHS can sustain.