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Minimally Invasive Prostate Surgery: Not Always Better

Today's NY Times reports on a JAMA article comparing outcomes from various types of prostate surgeries. The study found that increasingly-popular minimally invasive techniques have more of the complications men worry most about: impotence and incontinence.
“People intuitively think that a minimally invasive approach has fewer complications, even in the absence of data,” said Dr. Jim C. Hu, the study’s lead author, who is director of urologic robotic and minimally invasive surgery at Brigham and Women’s Hospital in Boston. “Men who were well educated and had higher incomes were actually more likely to embrace this approach, often due to aggressive marketing by hospitals that had spent $1.5 million to acquire the robots. I think the technology has been oversold.”
...

Dr. Peter Scardino, chief of surgery at Memorial Sloan-Kettering, said the study was important because it reported on data that did not come just from one medical center or one region.

“At the end of the day,” Dr. Scardino said, “what all the studies will show is that it’s not the tools the doctor uses, but the experience and skill of the surgeon. There’s nothing magical about the laparoscopic or robotic.”
How many hospital marketers are truly honest about a surgeon's skill? You don't see many ads saying "We've got this shiny new robot and our prostate surgeon just attended a seminar on how to use it so y'all come on in now!" There's truth in advertising and then there's TRUTH in advertising.

And, in a normally-distributed world, not everybody can be above average.


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