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From Technical Wonder to Malpractice Liability

Wolfgang Buschfort (win)April 23, 2004

Computerized surgery was seen as the way of the future until a few years ago. Now, about 200 patients in Germany alone have filed malpractice lawsuits because they can no longer walk after undergoing such an operation.

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The robot is unlikely to replace human surgeons any time soon.Image: dpa

Five years ago, Ursula Navrot received an artificial hip that had been fitted by one of Germany's first Robodoc machines.

"It fits real well, but I can't walk any more," she told German public broadcaster WDR. When Navrot goes out, even just for a short distance, she has to walk on crutches and rely on her husband to push her around in a wheelchair, she said. "I cannot go anywhere alone and am always dependent on the help of others," Navrot added.

She can't walk anymore because her tendons and muscle tissue were damaged during the operation. Hundreds of other patients complain about similar problems.

Surgeons on the other hand had expected the computerized cutter -- originally developed for the automobile manufacturing industry -- to increase precision and thereby also the durability of artificial hips. The machine cuts a cavity into the thighbone to make space for a prosthesis that is implanted afterwards.

Report: Robots not better than surgeons

Operation Krankenhaus Arzt
Image: BilderBox

But a recent study on surgery roboters commissioned by Germany's health insurance carriers has come up with different results. It's not proven that the robot guarantees a sturdier and more durable artificial hip than those fitted by surgeons themselves, according to Peter Schräder, a orthopaedic surgeon in the western German town of Essen.

"Quite to the contrary, surgeon-made hips are just as sturdy as those made by robots," he said, adding that a 2004 experimental study on human cadaver bones had shown this to be true.

While man and machine produce similar results, according to Schräder, radiation exposure and the risk of mistakes are higher with the robot. The surgeon believes that the introduction of the computerized surgeons, which cost about €500,000 ($595,000) a piece, was a mistake.

"A new method needs to produce some kind of positive result," Schräder said. "It either needs to be better for the patient or it needs to be cheaper for society as a whole. If you can't show that that's the case, there's really no point in introducing such a new kind of method."

Hospitals phase out machines

As a result, many hospitals have stopped using Robodocs after alleged malpractice cases started to surface. Officials for the company that produces Robodocs were not available for comment on Friday.

Other clinics that used a similar machine called Caspar had to shut down the machines after the company that produced it went bankrupt. Schräder, who contributed significantly to the recent report, doesn't believe they will be switched on again.

"Since this method is still in its trial phase, I think people will hold back on using it for regular patients," Schräder said.

It's still unclear whether patients who sue their surgeons will receive support from their health insurance carriers. But the latter have said that they want to publish the findings of the report immediately and make it accessible to everyone.