Costly Robotic Surgery 'More Accessible' After Opening Of New Sydney Training Facility

More Australian surgeons will be trained to use robots at the operating table, with the opening of the country's first robotic surgery training facility at Sydney's Royal Prince Alfred (RPA) Hospital.

The Surgical and Robotics Training Institute will have the capacity to train 400 surgeons a year and offer more public patients access to these less-invasive procedures for little or no cost.

Operating metres away from a patient while controlling guiding robotic arms could become a new norm for surgeons going into the future, but there are still questions over whether robots can do a better job.

"Robotic surgery allows us to perform complex procedures at a distance with great precision and great control," the institute's director, Professor Paul Bannon, said.

"We want to know how to teach robotic surgery and how to teach it better and we want to know exactly what the benefits to the patients are."

For more than a decade, robotic machines have largely been used in private hospitals for procedures like robotic prostatectomy to treat prostate cancer and robotic mitral valve surgery for heart failure patients.

Nepean Hospital has been using robots for four years in the public system, however surgeons still had to travel to the United States for some of their training.

Most Australian surgeons have had to travel to California to develop their robotic skills and the institute will be the first in the southern hemisphere to offer comprehensive training.

"It made it very difficult for local surgeons from Australia to get there because of their busy schedules," one of the institute's trainers, urologist Dr Scott Leslie, said.

"These training centres were only available in the US."

Pensioner had costly robotic surgery for free
In December last year, Terry Lagogiane had a robotic procedure to treat prostate cancer as a public patient at RPA Hospital.

The 69-year-old was relieved he did not need chemotherapy and was able to go home within 24 hours.

"I'm very happy. There's no big scars, just one, two, three, four keyhole points. The fifth one is gone already," he said.

With three robots now available in Sydney's public system, the pensioner was able to access the procedure for free.

Having a robotic procedure in a private hospital costs at least $5,000 more than normal surgery.

The out-of-pocket costs include $2,000, which covers the extra time needed in theatre, while an additional $3,000 is billed to pay for non-reusable robotic instruments.

Patients could also face discretionary surgeon fees of up to $15,000 that may include a possible robotic premium.

Is robotic surgery a better option?
A 2016 Australian study published in prestigious journal The Lancet questioned the value of using expensive robotic technology to treat prostate cancer patients.

The study compared patients who had either a robotic or a non-robotic surgery and found there were not many differences in the outcomes, including the patient's urinary and bowel function or recovery time.

The robot used to train Australian doctors costs about $4 million, and it is yet to be seen whether any short or long-term health benefits it helps produce justify the bottom line.

"There's no doubt that there is a value add to robotic surgery, simply speak to the patients who have had robotic surgery but the overall big picture ... that still needs to be refined," Professor Bannon said.

The Surgical and Robotics Training Institute will also collect patient outcome data and present its findings to state and federal governments.

"We want to know what the cost is to the community and we want to be able to feed that back to the decision makers that make those big fiscal decisions," he said.

A robotics surgery symposium will be held in late June where doctors will discuss having a national register for surgeons who provide robotic treatment. The meeting will also address discretionary surgeon fees for such procedures.



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