tag:blogger.com,1999:blog-4968787219619380438.post4393497696215705409..comments2023-09-21T04:02:29.457-04:00Comments on Skeptical Scalpel: Read the entire paper not just the abstractSkeptical Scalpelhttp://www.blogger.com/profile/13206922456661320751noreply@blogger.comBlogger8125tag:blogger.com,1999:blog-4968787219619380438.post-29302023073211423302012-08-11T14:37:42.099-04:002012-08-11T14:37:42.099-04:00Yes, length of stay is a "soft" endpoint...Yes, length of stay is a "soft" endpoint and can easily be influenced by non-medical issues such as you describe. There are also things like "I can't get a ride," "I don't want to go to that rehab center," "I refuse to go home" and so on.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-6748460134202238532012-08-08T16:10:01.939-04:002012-08-08T16:10:01.939-04:00Another misleading detail, is to count the days th...Another misleading detail, is to count the days the patients stay at the hospital. I have personally witnessed how a centre, trying to convince the rest of world of the "fantastic" short hospital duration of treatment following Robotic cystectomies - it turned out that they sent the patients on day 5 or 6 to a resting-home with hospital facilities, nurses and daily medical rounds. The postoperative stay was not different from open cystectomies in any regular centre of the same size keeping the patients full time. That is 10-14 days.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-55717702410463147132012-08-07T16:46:23.460-04:002012-08-07T16:46:23.460-04:00MD, Thanks. That is still true. They like to omit ...MD, Thanks. That is still true. They like to omit the so-called "docking time," which can be more than 20 minutes.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-63672168483951259732012-08-07T11:34:21.417-04:002012-08-07T11:34:21.417-04:00I might have made a similar comment on another pos...I might have made a similar comment on another post at some point -- I'm not a surgeon but I looked into robotic surgery evidence in 2010 when I was working with ABC News, and even the best data (quicker operative times) were misleading -- they measured skin-to-skin, ignoring equipment setup!mdawarehttps://www.blogger.com/profile/11511273712090189564noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-26239155798932621142012-05-03T17:13:30.301-04:002012-05-03T17:13:30.301-04:00I guess they could have used the term "less e...I guess they could have used the term "less easy," but they chose "more difficult" instead. The robotic single-port procedure took 75% longer. To me that suggests significantly more difficult.Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-75637522056170357662012-05-03T16:29:59.763-04:002012-05-03T16:29:59.763-04:00Well, I'll confess that I don't have a sub...Well, I'll confess that I don't have a subscription to the Archives of Surgery and I'm not quite committed enough to pony up $30, so I'm reliant on you to tell me if there were any meaningful comparisons in the full text of robotic single site surgery to laparoscopic single site surgery. I gather that they also made comparisons to traditional four port laparoscopic surgery, but surely there must have been some text related to single site laparoscopic surgery.<br /><br />And to be nit-picky, not being as easy as traditional four port laparoscopic surgery does not mean that it's not still easy.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-61961197108598554462012-05-03T10:27:19.393-04:002012-05-03T10:27:19.393-04:00I disagree. If you look at Table 1, which summariz...I disagree. If you look at Table 1, which summarizes the entire gist of the paper, you will see that more than half of the comparisons listed are to 4-port laparoscopic surgery. In addition, two of the 5 surgeons had not even done single-incision laparoscopic cholecystectomy before.<br /><br />The misleading part is also the abstract's assertion that robotic is easy [their own data says it's not] and safe [an N of 100 cases does not prove safety].Skeptical Scalpelhttps://www.blogger.com/profile/13206922456661320751noreply@blogger.comtag:blogger.com,1999:blog-4968787219619380438.post-49170554068242238782012-05-03T09:56:14.284-04:002012-05-03T09:56:14.284-04:00Might be misleading if they were comparing robotic...Might be misleading if they were comparing robotic single incision to standard laparoscopic surgery, but they were comparing it to single-incision laparoscopic surgery.Anonymousnoreply@blogger.com