Read this on the American College of Surgeons message board. Thought I would share info from the trenches. This is just one of many such posts but it says it all. Pay attention to the last paragraph. Especially Longterms!
Let me preface this by saying that I am one of these robotic general surgeons you are asking about. I converted to robotics 2 years ago and since that time have done numerous colectomies, LARs, Nissens, distal pancreatectomies, hernia repairs, one Ivor Lewis esophagectomy and and yes, cholecystectomies.
Answer to your first question depends on were you stand. The nay sayers will tell you that the robot is expensive and adds little to conventional laparoscopy. But the proponents of this technology will tell you that per case costs are lower than laparoscopy, complications are less and LOS is shorter. Having extensive advanced laparoscopy experience I can tell you that I can do much more with a robot that I could ever do with straight sticks. This technology is only at its beginning and will get much more sophisticated as time goes on. The latest model of the da Vinci robot (Xi) is already much more capable that its predecessor Si and it addresses many of the criticisms and limitations of the Si platform. In my opinion the technology is here to stay and patients will ask for it just like they asked for lap cholecystectomies 20 years ago.
Even if you disagree with everything I said, there is one thing you should consider: your own longevity as a surgeon. Laparoscopy is physically demanding due to poor ergonomics and acrobatics we are required to perform during even routine operations. My biggest complaint after finishing a robotic case is that my forehead feels little numb from pressing it too hard against the robot's binoculars. My arms and my back feels fine. In this age of surgeon shortage, the robot may go a long way in helping us stay on the job just a little longer.
