Surgical Robot Linked to Injuries at New Hampshire Hospital

The da Vinci surgical robot, marketed by Intuitive Surgical Inc., is being investigated because of reports of patient injuries at a small New Hampshire hospital. The reported injuries include two patients with lacerated bladders and one woman who required four subsequent surgeries after <"">errors using the machine.

According to The Wall Street Journal, the da Vinci came on the market in 2000, and is now employed in 853 U.S. hospitals. It is used in a variety of surgical procedures, from removing cancerous prostates to heart surgeries. The machine, which can cost anywhere between $1 million to $2.25 million, boasts four remote-controlled arms and a sophisticated camera that allows surgeons to operate through small incisions with greater precision and visibility.

The injuries detailed by The Wall Street Journal occurred at Wentworth-Douglass Hospital in New Hampshire. Surgeons there have used the da Vinci robot roughly 300 times in the past four years. Apparently, that is just a fraction of the use the same robot receives at large hospitals, and that – surgeon inexperience – could be the problem.

According to the Journal report, some surgeons have questioned the way da Vinci is marketed. Apparently, Intuitive Surgical touts the robot as a way for hospitals to increase revenues and market share. Wentworth-Douglass, which competes with six other hospitals, began leasing a da Vinci robot in 2006, hoping to gain an edge. No hospital within a 30 mile radius of Wentworth-Douglass has a da Vinci, the Journal said.

After acquiring it, the hospital began marketing the da Vinci in advertisements on radio, television and in the local newspaper. Former and current medical staff also told the Journal that surgeons at Wentworth-Douglass were pressured to use the machine.

At least two surgeons at Wentworth-Douglass had opposed using the da Vinci there, and both told the board of trustees it wasn’t need at a hospital of its size. One of them, Dr. Robert Lambert, told the Journal that pressure to use da Vinci was one of the reasons he eventually left Wentworth-Douglass.

Other members of the medical staff were critical of the training they received with the device, saying it was insufficient. According to the Journal, that training consisted of two days of operating on pig and human cadavers at a hospital in New Jersey. The training was paid for by Intuitive, which includes it with the lease of the machine.

Once Wentworth-Douglass surgeons received their training, surgeons from other specialties supervised the first few da Vinci surgeries of newly trained doctors. After four such surgeries, the hospital allowed them to use da Vinci unsupervised on their patients.

Not everyone at Wentworth-Douglas was happy with this arrangement. According to the Journal, four urologists resisted using the robot without more training. Three of those doctors eventually left the hospital.

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