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Robots don’t perform surgery, surgeons do

BMJ 2011; 343 doi: (Published 26 October 2011) Cite this as: BMJ 2011;343:d6830
  1. David M Lloyd, consultant surgeon and honorary senior lecturer, University Hospitals of Leicester, Leicester
  1. dmlloyd1{at}

Over the past five years we have seen a huge rise in the number of robotically performed operations worldwide. Most patients who undergo radical prostatectomy in the United States, for example, now have “robotic surgery” or “robotically assisted surgery.” This trend is likely to continue despite the lack of evidence from multicentred randomised controlled trials to prove that it is safer than conventional surgery. Sceptics think that this development may be industry driven, because robotic surgery is now part of a billion dollar market in the United States. Attractive as they may appear, surgical robotic machines are very expensive. They cost between £1m (€1.2m, $1.6m) and £3m, have annual servicing fees of about £200 000, and have additional disposable costs of at least £1000 a procedure.

In addition to the risks, costs, and need for training, a fundamental problem remains with the definition of robotic surgery, because robots themselves do not perform any procedure independently. We are, therefore, misleading ourselves as clinicians …

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