BY GREGORY TWACHTMAN
Frontline Medical News
Despite the lack of a clear-cut cost-efec- tiveness case, it appears that the use of robotics in surgery is on its way to becoming the norm.
What may help make that cost-efective-ness case is time, as the hardware becomes
cheaper and the technology becomes more
“I think there are many surgeons who are
doing robotic surgery who truly believe that
the current of state of the art will bear only a
partial resemblance to the state of the art 5-10
years from now,” Dr. Henry Pitt, chief quality
ofcer of the Temple University Health Sys-
tem, Philadelphia, said in an interview. “And
part of the persistence by many of the robot-
ic surgeons, while they fully understand that
what they are doing is not cost efective now,
is that they believe that the next few genera-
tions of this technology will become the state
of the art and will become cost efective.”
Dr. Pitt, an ACS Fellow, compared the
VOL. 11 • NO. 11
Pre s orte d Sta n d ard
banon Jct. K Y
A C S Surgery N e ws C H A N G E SE R VIC E R E Q U ES T E D
151 Fairchild Ave.,
S uite 2,
Plainvie w, N Y 11803-1709
See Robotic Â page 10
7 l Commentary
Dr. Patrick Bailey discusses the
actions on Capitol Hill on funding
graduate medical education.
8 l Practice Economics
CMS 2016 fee schedule includes a relaxation
of the requirement for the two-midnight rule,
and two new advance care planning codes.
22 l Surgical Oncology
Dr. Otis Brawley comments on
data showing that black men get
inferior care for prostate cancer.
Online & In-Depth
Dr. David A. Baron, a psychiatrist, gives his
views on the role of psychiatry in managing the
bariatric surgery patient. http://goo.gl/uLwQ4p
The Art of Negotiation,
Gathering the Critical Information
Dr. Joseph Sakran continues his series
on successful strategies for negotiating
a satisfactory employment contract.
Â See page 9
BY MARY ANN MOON
Frontline Medical News
The risk of self-harm emergencies increases by 50% after bariatric surgery, according to a report published online in JAMA Surgery.
Mental health problems are common among both
morbidly obese adults and patients undergoing bariatric
surgery, and a recent meta-analysis of 30 studies found
that suicide risk was four times higher among patients
undergoing bariatric surgery than in the general population. To examine this association, researchers performed
a population-based longitudinal cohort study comparing
self-harm behaviors during the 3 years before bariatric
surgery with those during the 3 years after bariatric surgery in all 8,815 adults who underwent gastric bypass, intestinal bypass, and sleeve gastrectomy in Ontario during
a 5-year period.
This cohort refects the practice of approximately 200
surgeons. Self-harm behaviors were categorized as medication overdose, alcohol-related, poisoning by toxic chemicals, or physical trauma. Approximately 64% of the study
population had a history of anxiety disorders, 7.8% had
general mental health disorders, and 0.6% reported alcohol
misuse before undergoing bariatric surgery, wrote Junaid A.
Bhatti, Ph.D., of the department of evaluative clinical sci-
See Bariatric Â page 15
The volume of robotic-assisted procedures grew by more than 50% between 2011 and 2014,
according to Surgical Intuition, Inc., maker of the da Vinci robotic surgical system.
Bariatric patients at
extra risk for self-
64% of patients had anxiety disorders
Robotic surgery progress:
Is resistance futile?