New Studies Demonstrate Benefits of Robotics for Lung Surgery

New Studies Demonstrate Benefits of Robotics for Lung Surgery

SUNNYVALE, Calif., April 28, 2014 (GLOBE NEWSWIRE) -- Two new studies on the
effect of different surgical techniques on patient outcomes showed
robotic-assisted lung surgery can deliver equal or better results compared
with both open surgery and the most widely used minimally invasive surgical
method. One of the studies showed that this result could be achieved by
surgeons who are new to robotics and who work in community hospitals.

Both studies were on lobectomy, a procedure to remove cancerous lung tissue. A
lobectomy requires access to the lungs through incisions made between the ribs
of the thorax, or chest cavity.

The studies compared three types of surgical technique: open thoracotomy,
which uses a large incision between the ribs; robotic-assisted thoracoscopic
surgery, which is a minimally invasive approach using small incisions between
the ribs; and the more widely used minimally invasive method, called
video-assisted thoracoscopic surgery (VATS). VATS is performed with hand-held

One study, Farivar, et al, published in the January/February edition of
Innovations, found a number of improved outcomes with robotic-assisted
surgery, compared with both open surgery and VATS. The other study, Adams, et
al, published in the April edition of The Annals of Thoracic Surgery, focused
more on the surgeons' early cases and whether a community practice setting
would affect their outcomes. Adams concluded that robotic-assisted surgery was
safe and effective in a variety of settings, including community hospitals. In
addition, even for surgeons who are new users, Adams concluded that
robotic-assisted thoracoscopic surgery can deliver outcomes equal to VATS and
better outcomes than open thoracotomy.

Both studies compared the authors' data with a national database of 5,913
patients who had open surgery and 4,612 patients who had VATS. The Farivar
study collected data from 181 patients from two healthcare institutions. The
Adams study specifically looked at the first 20 robotic cases of six surgeons
at six institutions (120 robotic-assisted lung surgeries). Patients among the
three surgical groups were similar in age, gender, body mass index, current
and past smoking status, lung function and clinical tumor stage.

In both studies, robotic-assisted surgery was associated with improved
outcomes compared with open surgery, including:

  *Between 2 and 4 fewer days in the hospital
  *Fewer blood transfusions
  *Shorter use of a chest tube by a day or more; a chest tube is used to help
    the lungs re-inflate and return to normal function after surgery
  *Fewer air leaks lasting more than 5 days; a persistent air leak in the
    lung is one risk of lung surgery

The limitations of these studies include the studies' design. Neither study
randomized or case-matched their patients, but instead compared their
institutions' robotic cases with database cases. The database of VATS and open
surgeries used for comparison is a nationally administered repository and is
subject to variations in reporting by individuals who voluntarily submit data.
Additionally, Adams notes the relatively small size of their robotic-assisted
surgery group. Farivar notes data suggesting that there were significantly
more patients with advanced disease in their thoracotomy group than in the
robotic-assisted group. This consideration may help explain some of the
increased complications and the duration of chest tube use required in the
Farivar open surgery group.

The funding for the Adams study was provided by Intuitive Surgical, Inc. Study
authors Doctors Adams, Bolton and Stephenson have financial relationships with
Intuitive Surgical. Farivar study author Robert J. Cerfolio, MD, is a
consultant to Intuitive Surgical. Additional financial disclosures by the
Farivar study authors are that Eric Vallières, MD, serves on the board of
GSK-Bio, Philadelphia, PA USA, and Myriad, Salt Lake City, UT USA, and
receives compensation as a member of the speaker's bureau of Genentech, San
Francisco, CA USA, and Synthes, Inc, West Chester, PA USA. Alexander S.
Farivar, MD; Ariel Knight, BA; Ayesha Bryant, MD; Vijaya Lingala, PhD; Ralph
W. Aye, MD; and Brian E. Louie, MD, declared no conflicts of interest.

AboutIntuitive Surgical, Inc.

Intuitive Surgical, Inc.(Nasdaq:ISRG), headquartered inSunnyvale, Calif., is
the global leader in robotic-assisted, minimally invasive surgery.Intuitive
Surgicaldevelops, manufactures and markets thedaVinci^®Surgical
System.Intuitive Surgical'smission 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,
the da Vinci Surgical System is designed to scale, filter and seamlessly
translate the surgeon's hand movements into more precise movements of the
EndoWrist instruments. The net result is an intuitive interface with improved
surgical capabilities. By providing surgeons with superior visualization,
enhanced dexterity, greater precision and ergonomic comfort, the da Vinci
Surgical System makes it possible for skilled surgeons to perform more
minimally invasive procedures involving complex dissection or reconstruction.
Potential benefits are specific to the procedure as well as the model da Vinci
System referenced in the footnoted publications. For more information about
clinical evidence related to da Vinci Surgery, please visit

Surgical Risks

All surgery presents risk, including da Vinci^® Surgery and other minimally
invasive procedures. Serious complications may occur in any surgery, up to and
including death. Examples of serious or life-threatening complications, which
may require prolonged or unexpected hospitalization, include injury to tissues
and/or organs, bleeding, infection and/or internal scarring that can cause
long-lasting dysfunction and/or pain. Risks of surgery also include the
potential for equipment failure and/or human error. Results, including
cosmetic results, may vary.

Risks specific to minimally invasive surgery, including da Vinci Surgery,
include temporary pain and/or nerve injury associated with positioning;
temporary pain and/or discomfort from the presence of air or gas; a longer
operation and time under anesthesia and conversion to another technique. If
your surgeon needs to convert the surgery to another technique, this could
result in a longer operative time, additional time under anesthesia,
additional or larger incisions and/or increased complications.

Patients who bleed easily, who have abnormal blood clotting, are pregnant or
morbidly obese may not be candidates for minimally invasive surgery, including
da Vinci Surgery. Patients should talk to their doctor about his/her surgical
experience and to decide if da Vinci Surgery is right for them. Patients and
physicians should review all available information on non-surgical and
surgical options in order to make an informed decision. For important safety
information, including surgical risks and indications and contraindications
for use, please also refer to

Forward-Looking Statement

This press release contains forward-looking statements within the meaning of
the Private Securities Litigation Reform Act of 1995. 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
those under the heading "Risk Factors" in our annual report on Form 10-K for
the year ended December 31, 2013, 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, except as
required by law.

CONTACT: Intuitive Surgical Corporate Communications
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