Robotic heart surgery: making repairs without lifting the hood

CHICAGO, Nov. 19 For the first time in the United States, open-heart surgery was performed without opening the chest, in more than a dozen patients, researchers reported in preliminary results presented today at the American Heart Associations Scientific Sessions 2002.

In this procedure, surgeons remotely maneuver robotic arms from a seat in front of a console away from the patient. Instead of opening the chest and cutting the skin and muscle to view the area, surgeons make four holes (8 to 15 millimeters each) through which robotic arms are inserted. The robotic arms include one with a camera-like device to transmit the image to the console. The other arms are fitted with operating instruments.

Surgeons used this new procedure to successfully repair the hearts of patients with atrial septal defect (ASD) or patent foramen ovale conditions in which people are born with an opening between the hearts two upper chambers. This opening allows some blood from the left atrium to return to the right atrium, instead of flowing through the left ventricle, out the aorta and to the body. Its repaired either by plugging the hole with a patch or suturing the hole closed.

Open-heart surgery traditionally requires that surgeons make a foot-long chest incision to cut patients breastbones in half.

We wanted to know if it was possible to operate inside the hearts of these patients without making any incisions, says Mehmet Oz, M.D., director of the Heart Institute at Columbia-Presbyterian Medical Center in New York. Not only did we show that the operation is feasible, but we demonstrated it in more than a dozen patients.

During 12 months, 15 patients (ages 22 to 68) underwent ASD repair using the robotic technology, called the Da VinciTM system.

Although the equipment is costly, this is definitely part of the future, says Michael Argenziano, M.D., lead author of the study and director of robotic cardiac surgery at Columb

Contact: Carole Bullock
American Heart Association

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