Public Perceptions On Robotic Surgery, Hospitals With Robots, and Surgeons That Use Them

Joshua A Boys, MD, Evan T Alicuben, MD, Michael J DeMeester, Stephanie G Worrell, MD, Daniel S Oh, MD, Jeffrey A Hagen, MD, Steven R DeMeester, MD. Keck Medical Center of USC

Introduction: The use of robotic-assisted surgery (RS) has rapidly increased, but public perceptions about RS are largely unknown. The aim of this study was to use a web-based survey to gain insights into the general understanding of RS and its use both within the US and internationally.

Methods: A web-based survey with 31 multiple choice or free-text questions was created and the link widely distributed by email. Surveys were collected from July–September 2014 using SurveyMonkey® (SurveyMonkey Inc., Palo Alto, CA,

Results: There were 789 survey participants and of those 747 (95%) surveys with the majority of questions answered were used for analysis. The mean age of respondents was 38 years (range 18-90) and 58% were female. Most (94%) were from the US. The majority (89%) had a college or post-graduate degree. Over half (53%) had a background in healthcare and 13% were physicians. Only 14% had not previously heard of RS. Most respondents (78%) identified RS as being most similar to laparoscopic or minimally invasive surgery but 22% thought the robot operated autonomously or in response to verbal commands and 14% thought that the robot could do the wrong operation. Overall 72% thought RS was safer, faster, less painful or offered better results, but 60% were concerned that the robot might malfunction. Forty-five percent would have RS if available and 40% of those would personally pay an additional $1000 and of those 16 % would pay $10,000 to have RS. Hospitals with a robot were thought to be better hospitals by 50% of respondents and 26% thought surgeons using the robot were more skilled. When given a choice almost half would prefer a world-renowned surgeon who they had never met to remotely perform RS rather than a non-expert surgeon that they had met and who performed RS onsite. Comparing genders, females were less likely to prefer RS (p = 0.009), more likely to believe the robot acted autonomously (p = 0.005) and had more uncertainty about the chance of robot malfunction (62% vs. 57%, p=0.003). Compared to non-physicians, fewer physicians perceived RS was safer, faster, less painful or produced better results (30% vs 78% p<0.001) and fewer physicians would prefer RS if they needed surgery (30% vs 49% p=0.001). Respondents from the US were more likely to believe that hospitals with RS were better hospitals compared to respondents from outside the US (53% vs. 37%, p = 0.04). There was no significant difference between US and non-US individuals (47% vs. 36%) who would prefer RS and pay an extra $1000 to have it (39% vs. 56%).

Conclusions: While most survey respondents knew of RS and had the perception that it offered advantages over other forms of surgery, these perceptions were less common among females and among physicians. Insights into the lack of understanding about the details of RS point out the importance of patient education when RS is proposed.

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