Two Decades, Ten Million Procedures, Over 29,000 Publications

For more than two decades, surgeons around the world have performed more than 10 million procedures using Intuitive’s minimally invasive surgical systems. This pace is accelerating—in just the past year, Intuitive systems have been used in over 1.5 million surgeries. But clinical practice is only part of the story. Over the past two decades, thousands of researchers have studied Intuitive systems and how they can be used in a variety of procedures.

“As a company, we value this research enormously,” says Myriam Curet, Intuitive’s chief medical officer. “Scientific inquiry is essential for the advancement of medical care, and patients are getting better care today because so many diligent and thoughtful researchers are meticulously examining our systems.”

Over the past 24 years, more than 29,000 peer-reviewed articles have studied and analyzed Intuitive robotic systems. These papers include a range of publications, such as randomized studies, reviews, prospective and retrospective trials, and lab research. Over that time frame, there have been more than 300 randomized controlled trials and more than 1,000 prospective clinical trials. In 2021 alone, scientists published more than 3,700 articles on Intuitive systems. Find out about some of this research on our clinical evidence page.

Much of this work—more than 18,000 studies—has focused on Intuitive’s da Vinci surgical system. Some of this research has analyzed the clinical outcomes in key procedures. For instance, one study found that compared to open surgery, colectomy with the da Vinci system was linked to shorter hospital stays, lower rates of blood transfusion, and lower rates of complication. Other studies have shown comparable or lower rates of readmission, reoperation, and mortality through 30 days; operative times were found to be comparable or longer.^1-3

New ways to leverage surgical data

As Intuitive continues to focus on the future of robotic surgery, new research is helping to point the way forward. Scientists across the globe are exploring a wide range of innovative approaches: new indications for robotic surgery; innovative AI tools to help surgeons more precisely target harmful tissue and avoid healthy structures; and new ways of leveraging data to better train fledgling surgeons.

“There is just so much that we can learn, so many areas where we can improve,” says Andrew Hung, a urologic surgeon at the University of Southern California. “It’s an incredibly exciting time to be studying robotic surgery.” Last year, he and his colleagues published a study analyzing surgical data and pinpointed 11 procedural metrics that were critical in determining how well patients recovered continence after robot-assisted prostatectomies.

“My experience has been very positive,” says Michael Fields, a gynecologic surgeon in Knoxville, Tenn., “As we used the da Vinci system, we saw improvements in some outcomes compared with open and laparoscopic procedures.” Dr. Fields, who began using the da Vinci system in 2006, says the accumulation of studies is reassuring, and “provides essential validation of (his) own experience.” He notes that while not every study finds benefits for gynecologic robotic surgery compared with alternatives, the overall gist of the research is that Intuitive systems add value for patients, surgeons and hospitals.

Examining the economic value of robotic surgery

Researchers are also examining the potential financial and economic benefits of robotic surgery. Robotic procedures tend to cost more up front than open or laparoscopic procedures; proponents argue that these costs are counterbalanced by a range of medical benefits, such as reduced time spent in the hospital after the surgery. A computer modeling study published earlier this year compared robotic-assisted radical prostatectomy with open and laparoscopic-assisted radical prostatectomies. The researchers found that the robotic approach cost less than laparoscopic and slightly more than the open procedure.

In another study, from 2020, scientists analyzed costs for five robotic procedures: radical prostatectomy, hysterectomy, partial colectomy, radical nephrectomy, and partial nephrectomy. They examined nearly 16,000 procedures in the U.S. between 2012 and 2017, and found that overall, robotic surgery was associated with lower out-of-pocket patient costs for all five types of procedures.

Moreover, researchers have been looking into the benefits of Intuitive systems for clinicians. The practice of surgery can be physically demanding—clinicians must often stand for hours, sometimes in uncomfortable positions, peering down intently at the patient. Some ergonomic studies have found that robotic-assisted surgery can decrease these physical demands. Over time, this reduced toll has the potential to help surgeons avoid repetitive strain injuries.

As Dr. Fields notes, the research on Intuitive systems continues to grow and evolve. “I think there is so much more we can do with robotic surgery,” he says. “I can’t wait to see what the science discovers about how it can help us help our patients.”

1. Benlice C, Aytac E, Costedio M, Kessler H, Abbas M, Remzi F, Gorgun E. Robotic, laparoscopic, and open colectomy: a case‐matched comparison from the ACS‐NSQIP. Int J Med Robot. 2017 Sep;13(3). doi: 10.1002/rcs.1783.
2. Moghadamyeghaneh Z, Hanna MH, Carmichael JC, Pigazzi A, Stamos MJ, Mills S. Comparison of open, laparoscopic, and robotic approaches for total abdominal colectomy. Surg Endosc. 2016;30(7):2792-2798. doi:10.1007/s00464-015-4552-8.
3. Rausa E, Kelly ME, Asti E, Aiolfi A, Bonitta G, Bonavina L. Right hemicolectomy: a network meta-analysis comparing open, laparoscopic-assisted, total laparoscopic, and robotic approach. Surg Endosc. 2019;33(4):1020-1032. doi:10.1007/s00464-018-6592-3