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Gynecologists Urge Caution on Robotic Hysterectomies

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For Intuitive Surgical, hysterectomies have been a notable area of growth, rising 26 percent last year.

But now the president of the American Congress of Obstetricians and Gynecologists is urging caution.

In a strongly worded statement on Thursday, James Breeden said:

"Many women today are hearing about the claimed advantages of robotic surgery for hysterectomy, thanks to widespread marketing and advertising. Robotic surgery is not the only or the best minimally invasive approach for hysterectomy. Nor is it the most cost-efficient. It is important to separate the marketing hype from the reality when considering the best surgical approach for hysterectomies."

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Breeden never mentioned Intuitive by name, but the company is generally regarded as the only player in robotic surgery and currently owns the robotic hysterectomy market.

Among his other statements:

•Expertise with robotic hysterectomy is limited and varies widely among both hospitals and surgeons.

•There is no good data proving that robotic hysterectomy is even as good as—let alone better—than existing, and far less costly, minimally invasive alternatives.

•Aggressive direct to consumer marketing of the latest medical technologies may mislead the public into believe they are the best choice.

Intuitive Surgical responded with a statement:

"We agree that patients need factual information about all of their treatment options and the evidence supports that robotic surgery has dramatically decreased the number of open hysterectomies in the US ... It is well documented in the clinical literature that a minimally invasive procedure compared to open is better for patients and saves cost for the entire health care system. Robotic surgery is a technological advance that is enabling more women to receive minimally invasive surgery."

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An analyst at Merrill Lynch, defending Intuitive, noted that the group's "basic message is no different" from recent statements several groups, including a study in the Journal of the American Medical Association, which said clinical results of robotic versus non-robotic "benign" hysterectomies aren't much different.

"We would say," the analyst added, "the only difference is that this statement is a little more aggressive in terms of criticizing the company itself and their marketing practices..."

He went on to say he was surprised to say the stock "is selling off so much."

My take: This is a significant statement.

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