EURURO-5583; No. of Pages 2 EUROPEAN UROLOGY XXX (2014) XXX–XXX
available at www.sciencedirect.com journal homepage: www.europeanurology.com
Platinum Priority – Editorial Referring to the article published on pp. x–y of this issue
Are We in a Robotic Surgical Bubble Market? Elisabetta Costantini a,*, Massimo Lazzeri b a
Department of Surgical and Biomedical Science, Urological and Andrological Clinic, University of Perugia, Perugia, Italy;
b
Department of Urology,
San Raffaele Turro, Vita-Salute San Raffaele University, Milano, Italy
The first bubble market occurred about four centuries ago. In November 1636, the price of tulip bulbs rose rapidly and sharply until a single bulb was selling for 10 times the annual earnings of a typical worker. Six months later, in May 1637, tulip bulb prices returned to their original values. Although the causes of this dramatic rise and fall are unknown, the ‘‘tulipmania’’ bubble market was clearly fueled by speculation rather than intrinsic value. Are we living in a robotic surgical bubble market? By the end of 1990s, introducing ‘‘robot help’’ had become more and more imperative. Minimally invasive laparoscopic surgery was failing to overcome its greatest limitations. Many kinds of reconstructive steps (eg, anastomosis) could not be performed well, if at all, because the rigid laparoscopic instruments could move and rotate along only two axes— inward, outward, clockwise, and counterclockwise—with four degrees of freedom. They could not duplicate the surgeon’s ability to apply pitch and yaw to their wrists, that is, to tilt manual instruments up and down or shift them from side to side. The urologic community understood that minimally invasive laparoscopic surgery was good for extirpation but not for reconstruction. In urology, robot-assisted sacrocolpopexy (RASC) has been introduced into reconstructive surgery. Female urology now has the advantages of manipulators, that is, a collection of wristed ‘‘servant’’ tools for the ‘‘master’’ surgeon, who sits at an ergonomically designed video console with an immersive three-dimensional (3D) display. In this month’s issue of European Urology, Serati and coworkers [1] present a systematic review of the impact of RASC on pelvic organ prolapse (POP) management. They collected 1488 RASCs from 27 studies, which had been conducted since 2006. Objective and subjective cure rates
ranged from 84% to 100% and from 92% to 95%, respectively. The conversion rate to open surgery was
available at www.sciencedirect.com journal homepage: www.europeanurology.com
Platinum Priority – Editorial Referring to the article published on pp. x–y of this issue
Are We in a Robotic Surgical Bubble Market? Elisabetta Costantini a,*, Massimo Lazzeri b a
Department of Surgical and Biomedical Science, Urological and Andrological Clinic, University of Perugia, Perugia, Italy;
b
Department of Urology,
San Raffaele Turro, Vita-Salute San Raffaele University, Milano, Italy
The first bubble market occurred about four centuries ago. In November 1636, the price of tulip bulbs rose rapidly and sharply until a single bulb was selling for 10 times the annual earnings of a typical worker. Six months later, in May 1637, tulip bulb prices returned to their original values. Although the causes of this dramatic rise and fall are unknown, the ‘‘tulipmania’’ bubble market was clearly fueled by speculation rather than intrinsic value. Are we living in a robotic surgical bubble market? By the end of 1990s, introducing ‘‘robot help’’ had become more and more imperative. Minimally invasive laparoscopic surgery was failing to overcome its greatest limitations. Many kinds of reconstructive steps (eg, anastomosis) could not be performed well, if at all, because the rigid laparoscopic instruments could move and rotate along only two axes— inward, outward, clockwise, and counterclockwise—with four degrees of freedom. They could not duplicate the surgeon’s ability to apply pitch and yaw to their wrists, that is, to tilt manual instruments up and down or shift them from side to side. The urologic community understood that minimally invasive laparoscopic surgery was good for extirpation but not for reconstruction. In urology, robot-assisted sacrocolpopexy (RASC) has been introduced into reconstructive surgery. Female urology now has the advantages of manipulators, that is, a collection of wristed ‘‘servant’’ tools for the ‘‘master’’ surgeon, who sits at an ergonomically designed video console with an immersive three-dimensional (3D) display. In this month’s issue of European Urology, Serati and coworkers [1] present a systematic review of the impact of RASC on pelvic organ prolapse (POP) management. They collected 1488 RASCs from 27 studies, which had been conducted since 2006. Objective and subjective cure rates
ranged from 84% to 100% and from 92% to 95%, respectively. The conversion rate to open surgery was
