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Evidence to Improve Care

Robotic-Assisted Minimally Invasive Prostatectomy

Ontario Health Technology Advisory Committee Recommendation

  • The Ontario Health Technology Advisory Committee recommends the establishment of a Provincial Steering Committee on robotic-assisted minimally invasive surgery.

Read the full OHTAC Recommendation report

The prostate is a gland found only in males that sits below the urinary bladder and in front of the rectum. Prostate cancer is the most common cancer among men causing about 27 percent of all cancers among Canadian men. If the cancer has not spread beyond the prostate, prostatectomy (a surgery that removes the prostate) and radiation therapy are used for treatment. Prostatectomy can be performed by conventional surgery or assisted by robotics. There is little Ontario-specific evidence on how effective robotic-assisted prostatectomy is or how often problems arise after surgery.

Health Quality Ontario Reviews Robotic-Assisted Radical Prostatectomy

The Da Vinci system is a robotic device used to perform surgery. Advantages of this system include minimal invasion, greater precision (by translating surgeons’ hand, wrist and finger movements into precise movements of miniaturized instruments), and three-dimensional imaging. This type of surgery has mostly been used for hysterectomy to treat cancers of the uterus entrance and lining and for radical prostatectomy to treat prostate cancer. Robotic-assisted minimally-invasive surgery costs more than other treatments and requires training of surgeons and other workers but can reduce many problems after surgery.

The Ministry of Health and Long-Term Care endorses this recommendation.

The Ministry of Health and Long-Term Care has provided the following response: Radical prostatectomy surgery is an insured service and physicians may perform that surgery by any method they deem appropriate (with or without robotics). Health Quality Ontario has continued to examine this topic and the Ministry looks forward to receiving additional recommendations from Health Quality Ontario regarding robotic-assisted prostatectomy.

Health Technology Assessment at Health Quality Ontario

As part of our core function to promote health care supported by the best available evidence, we use established scientific methods to analyze the evidence for a wide range of health interventions, including diagnostic tests, medical devices, interventional and surgical procedures, health care programs and models of care. These analyses are informed by input from a range of individuals, including patients and clinical experts. The Ontario Health Technology Advisory Committee — a committee of the Health Quality Ontario board of directors — reviews the evidence and makes recommendations about whether health care interventions should be publicly funded or not. Draft recommendations are posted on the Health Quality Ontario website for feedback. Final recommendations are approved by our board of directors and then shared with the Ministry of Health and Long-Term Care. For more detailed information, visit our Evidence to Improve Care pages.


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