Two New Analyses Demonstrate That Robotic-Assisted Surgery Results in Fewer Complications Compared With Open Surgery for

Two New Analyses Demonstrate That Robotic-Assisted Surgery Results in Fewer
Complications Compared With Open Surgery for Urologic Cancers

SUNNYVALE, Calif., Oct. 24, 2013 (GLOBE NEWSWIRE) -- In two independent
analyses comparing robotic-assisted surgery and open surgery performed on
patients with urologic cancers, researchers found that robotic-assisted
surgery results in fewer overall complications during and after surgery, less
blood loss and shorter length of hospital stay.

In the first analysis, which was published in this month's issue of Cancer
Treatment Reviews, the authors (Li K, Tianxin L, Xinxiang F, et. al.) reviewed
the available literature on the efficacy and advantages of robotic-assisted
radical cystectomy (RARC) versus open radical cystectomy (ORC) performed for
bladder cancer. Included in the analysis (962 patients in total) were one
randomized controlled trial, eight retrospective studies with prospectively
collected data and four retrospective studies.

Radical cystectomy, which is the removal of the entire bladder, nearby lymph
nodes, part of the urethra, and nearby organs that may contain cancer cells,
is a common procedure performed for patients with stage 2 or stage 3 bladder
cancer. According to the National Cancer Institute, bladder cancer is the
sixth most common cancer in the United States.^1 It is the third most common
cancer in men and the eleventh most common cancer in women, and causes
approximately 15,000 deaths each year.

The analysis shows that although RARC was associated with longer operative
time (p < 0.001), it may result in fewer overall complications during surgery
(p = 0.04), more lymph node yield (p = 0.009), less estimated blood loss (p <
0.001), a lower need for a blood transfusion (p < 0.001) and a shorter length
of hospital stay (p < 0.001). Positive surgical margins (leftover cancer
cells) did not differ significantly between the surgical techniques.
Sensitivity analysis on the prospective studies showed similar results except
that no significant difference was seen for lymph node yield and length of
stay between the two surgical techniques.

The second analysis, published in the World Journal of Urology by Dr. Gianni
Vittori from the Universita` di Firenze, compared kidney cancer patients who
had received robotic-assisted partial kidney removal with those who had
received open partial kidney removal. The two-year observational multicenter
analysis was promoted by the "Associazione GIovani Laparoscopisti
Endoscopisti" (AGILE), a non-profit foundation that involved six Italian
urologic centers.

This year, there will be an estimated 65,000 new cases and 14,000 deaths
related to kidney cancer in the United States. Since a majority of patients
are diagnosed when the tumor is still relatively localized (stage 1 and 2) and
are able to have surgery to remove the tumor, approximately 40 percent survive
for at least five years.

Dr. Vittori's analysis involved a total of 198 and 105 patients enrolled in
either open or robotic-assisted surgery groups, respectively. Prior to
surgery, the patients undergoing robotic-assisted partial kidney removal were
sicker (p = 0.04) and had tumors of smaller size (p = 0.002). While the
surgical results indicated the robotic-assisted patient group had longer
operative times (p<0.001), they benefited from less blood loss, fewer surgical
complications after surgery (p<0.001), fewer surgical complications that
required additional interventions or were life-threatening (p=0.001), and
shorter hospitalization times than the open surgery patients.

"As individuals and agencies seek to understand the impact of robotic-assisted
surgery on healthcare outcomes, evidence-based medicine and all peer-reviewed
clinical publications become increasingly important in understanding
appropriate treatment options," said Myriam Curet, MD, Chief Medical Advisor,
Intuitive Surgical. "Robotic-assisted surgery, while prevalent in urology and
gynecology, is now being utilized for other important procedures such as
cystectomy and partial nephrectomy where patients may benefit from a
minimally-invasive option over open surgery."

About Intuitive Surgical, Inc.

Intuitive Surgical, Inc. (Nasdaq:ISRG), headquartered in Sunnyvale, Calif., is
the global leader in robotic-assisted, minimally invasive surgery. Intuitive
Surgical develops, manufactures and markets the da Vinci^® Surgical System.
Intuitive Surgical's mission is to extend the benefits of minimally invasive
surgery to those patients who can and should benefit from it.

About the da Vinci ^ Surgical System

The da Vinci Surgical System is a surgical platform designed to enable complex
surgery using a minimally invasive approach. The da Vinci Surgical System
consists of an ergonomic surgeon console or consoles, a patient-side cart with
three or four interactive arms, a high-performance vision system and
proprietary EndoWrist^®instruments. Powered by state-of-the-art technology,
thedaVinciSurgical System is designed to scale, filter and seamlessly
translate the surgeon's hand movements into more precise movements of
theEndoWristinstruments. The net result is an intuitive interface with
improved surgical capabilities. By providing surgeons with superior
visualization, enhanced dexterity, greater precision and ergonomic comfort,
thedaVinciSurgical System makes it possible for skilled surgeons to perform
more minimally invasive procedures involving complex dissection or
reconstruction. For more information about clinical evidence related
todaVinciSurgery, please

All surgery presents risk, including da Vinci Surgery. Results, including
cosmetic results, may vary.Serious complications may occur in any surgery, up
to and including death. Examples of serious and life-threatening
complications, which may require hospitalization, include injury to tissues or
organs; bleeding; infection, and internal scarring that can cause long-lasting
dysfunction or pain. Temporary pain or nerve injury has been linked to the
inverted position often used during abdominal and pelvic surgery. Patients
should understand that risks of surgery include potential for human error and
potential for equipment failure. Risk specific to minimally invasive surgery
may include: a longer operative time; the need to convert the procedure to an
open approach; or the need for additional or larger incision sites. Converting
the procedure to open could mean a longer operative time, long time under
anesthesia, and could lead to increased complications. Research suggests that
there may be an increased risk of incision-site hernia with single-incision
surgery. Patients who bleed easily, have abnormal blood clotting, are pregnant
or morbidly obese are typically not candidates for minimally invasive surgery,
including da Vinci Surgery. Other surgical approaches are available. Patients
should review the risks associated with all surgical approaches. They should
talk to their doctors about their surgical experience and to decide if da
Vinci is right for them. For more complete information on surgical risks,
safety and indications for use, please refer to

This press release contains forward-looking statements within the meaning of
the Private Securities Litigation Reform Act of 1995, including statements
regarding our medical device reporting practices, related device malfunction
filings, product performance and the speed at which instrument changes can be
accomplished. These forward-looking statements are necessarily estimates
reflecting the best judgment of our management and involve a number of risks
and uncertainties that could cause actual results to differ materially from
those suggested by the forward-looking statements. These forward-looking
statements should, therefore, be considered in light of various important
factors, including the following: the impact of global and regional economic
and credit market conditions on health care spending; health care reform
legislation in the United States and its implications on hospital spending,
reimbursement and fees which will be levied on certain medical device
revenues; timing and success of product development and market acceptance of
developed products; procedure counts; regulatory approvals, clearances and
restrictions; guidelines and recommendations in the health care and patient
communities; intellectual property positions and litigation; competition in
the medical device industry and in the specific markets of surgery in which we
operate; unanticipated manufacturing disruptions or the inability to meet
demand for products; the results of legal proceedings to which we are or may
become a party; our ability to expand into foreign markets; and other risk
factors under the heading "Risk Factors"' in our report on Form 10-K for the
year ended December31, 2012, as updated from time to time by our quarterly
reports on Form 10-Q and our other filings with the Securities and Exchange
Commission. Statements using words such as "estimates," "projects,"
"believes," "anticipates," "plans," "expects," "intends," "may," "will,"
"could," "should," "would," "targeted" and similar words and expressions are
intended to identify forward-looking statements. You are cautioned not to
place undue reliance on these forward-looking statements, which speak only as
of the date of this press release. We undertake no obligation to publicly
update or release any revisions to these forward-looking statements to reflect
events or circumstances after the date of this press release or to reflect the
occurrence of unanticipated events.

^1 National Cancer Institute. "General Information About Bladder Cancer."
Available from:

CONTACT: Intuitive Surgical Corporate Communications
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