Robotic surgery

These two papers succinctly express the core issues of the 'robot debate'.Jones demonstrates the rapid skill acquisition of urologists who can now bypass the laparoscopic stage entirely.Sethia illustrates the huge cost implications, lack of evidence and limited use of the robot.The very handsome robot in my hospital lies dormant for 3 days or more per week: the predicted use in gynaecological and colorectal surgery remains unmet.Three DGHs and one teaching hospital in a 25-mile radius have these machines: would not one suffice until sufficient data confirm the health economic as well as clinical benefits?There is anecdotal evidence that referral rate is falling for prostatic brachytherapy in some robot-enhanced institutions -clinically justified or gizmo fuelled?Apparently, in Belgium, 40% of robots are in 'resting mode'.Is the robot like Concorde: an enormous technological masterpiece, hugely expensive but of benefit only to a few.