About 2.5 thousand this year, the operations will be performed in our country with the use of a surgical robot. This year could be a breakthrough for this type of surgery, according to a report published by the Modern Health Institute.
The first robotic operations in Poland were carried out in September 2009 at the Provincial Specialist Hospital in Wrocław. Only in 2016, the Specialist City Hospital in Toruń became the second center in our country that uses robotic surgery. Currently, 20 hospitals are equipped with surgical robots, most often of the Da Vinci type, as many as six of them are in Warsaw, and two more in centers near the capital.
“The development of robotic surgery in Poland shows that progress in medicine cannot be stopped. Contrary to the resistance of part of the medical community, without the support of the Ministry of Health or the public payer, without a separate valuation of procedures performed with the assistance of robots, the number of robotic surgeries is growing dynamically every year, "state the authors of the report" Robot Surgery in Poland 2021 ".
In over 11 years until the end of the first quarter of 2021, a total of 4,350 robotic operations were performed. Most often, these were radical prostatectomy procedures, i.e. removal of the prostate gland. So far, 2,970 such operations have taken place. As many as 1,260 of these procedures were carried out in 2020, only 190 of them were financed by the National Health Fund. Patients paid for the remaining procedures out of their own pocket or sought funding from other sources, such as health insurance. The cost of such an operation is high, ranging from 30,000 to 50,000. PLN.
In 2020, the National Health Fund financed 6,409 prostatectomy procedures performed using various methods. Most of them underwent laparoscopic procedures (3588) and the classic open technique (2821). The latter operations in prostatectomy should, in principle, not be performed any more. "Open surgery in the field of prostate surgery has absolutely no justification" - states in the report the president of the Polish Society of Urology, prof. Piotr Chłosta.
In his opinion, the advantages of robotic surgery are such as laparoscopic surgery, i.e. less extensive surgery, shorter patient stay in the hospital and shorter convalescence. However, robotic surgery is more precise and causes fewer complications, at least in areas such as urology. It also creates great advantages for the surgeon: thanks to a more comfortable position, he is less exposed to degenerative diseases of the spine and shoulder joints and the so-called "Laparoscopic surgeon thumb" (numbness of that finger).
The National Consultant in General Surgery, prof. Grzegorz Wallner claims, however, that the use of a robot, at least in general surgery, is still considered a clinical experiment that is not inferior to laparoscopic surgery. And the cost of a robotic operation is much greater and is generally nowhere fully reimbursed from the public system. Insurance companies or the patients themselves pay. And if the robot is to be used, it should be used by as many specialties as possible. The National Consultant also draws attention to the underinvestment of even basic surgical procedures in our country.
A few years ago, the Agency for Health Technology Assessment and Tariff System found no evidence of the superiority of robotic technology over laparoscopic technology. National Consultant in the field of Urology prof. Artur A. Antoniewicz in the report highlights the meta-analyzes of multicentre studies. They showed significant differences in favor of robotic surgery in prostate, kidney, upper urinary tract and bladder cancer.
In his opinion, the high price of the surgical robot is a myth, it costs less than an advanced computer tomograph or magnetic resonance imaging, and there are already hundreds of such devices in Poland. In our country, 25-30 operational robots are enough, which is not much more than those already in use. This number of robots should meet the needs of all surgical fields where their value has been proven by scientific research. (PAP)
Author: Zbigniew Wojtasiński