Direct-to-consumer advertising for robotic surgery.

Direct-to-consumer advertising is described as the promotion or marketing of a product directly from the seller to the consumer. We examined whether websites on Google™ provided clinical data or referenced peer-reviewed publications as part of their advertising in relation to the urological procedures. We created an electronic database for clinical direct-to-consumer advantages and/or disadvantages using the search terms "robotic sacrocolpopexy", "robotic prostatectomy", "robotic nephrectomy" and "robotic cystectomy" on the first 3 pages of Google™. Advertising was then classified based on presentation of: advantages only, disadvantages only, and both advantages and disadvantages. We further classified the information based on whether peer-reviewed references were present on the webpages and the type of Google webpage. A total of 25 websites were found to have information on advantages and disadvantages of robotic sacrocolpopexy. Most of these websites with advantages only provided references for their claims (n = 29%), while 71% of websites with both advantages and disadvantages provided references. When reviewing the content on the websites with advantages only, we found the following most common advantages: shorter recovery time, decreased blood loss, and less pain. We found the results to be nearly identical for each procedure. Direct-to-consumer advertising is common among robotic surgery. There is significant bias promoted on the benefit of robotic surgery regardless of the web-based source of information. The AMA Ethics Committee suggests that we need to further elucidate the impact of direct-to-consumer advertising on patient health and medical care. Websites should follow the AMA code to present balanced information to better inform patients about expectations.