Future of heart surgery seen in robotics
Future of heart surgery seen in robotics
Keywords: Healthcare, Surgery
Dr Robert Michler, chief of cardiothoracic surgery at Ohio State University Medical School, Columbus, Ohio, has reported on the success of a very recent procedure that is "no ordinary bypass". It replaces the surgeon's hands with two long robotic arms that will enter the patient's body through narrow gaps between the ribs, cutting holes no bigger than a US five-cent piece, known as a nickel. He explained, "this is a far cry from the usual 6 to 8in. incision straight through the breastbone".
"This", he told a press conference of US medical publications, as reported by Time, a leading US weekly magazine, "is a marked advance in that, besides eliminating almost entirely what had heretofore been a quite significant scar, this will reduce trauma to the patient's body, speed his recovery, and minimise the risk of infection". To Dr Michler, there is "no question but that the future of heart surgery lies in robotics",
The University Medical Center heart surgery specialist is a veteran of more than 3,000 open-heart operations and over 700 transplant procedures. Dr Michler expressed his delight that the US Food & Drug Administration (FDA) has given its approval of a robotic partial bypass procedure, noting that with more than 500,000 heart bypass operations performed now each year in the USA alone,surgeons everywhere "are anxious to learn ways to improve this important procedure". Robotic surgery is finding its way into medical centers across the USA.
Dr Michler explains his procedure: an incision, a small round hole through which the robotic arm enters the patient's chest, left side. First, a camera enters, next a miniature forceps, and finally a cantery, a tool used to isolate the artery and help assure proper blood-flow. As the surgeon steps back, the robots springs to life, looking like the legs of an oversized metallic spider,both outside and inside the patient's body. The model was perfected by the Intuitive Surgical Corp. of Mountain View, California.
Dr Michler next explains that "about 15ft from the operating table, a Dr Randall Wolf sits hunched over a console resembling something from a video game arcade. He peers into a 3D display that gives him a surprisingly clear view,magnified by up to ten times, inside the patient's chest".
"This is called a da Vinci robot and with it, Dr Wolf can see the top of the beating heart, the bulge of every rib and the outline of the artery that he needs to reposition." As the team of doctors and nurses watches in the operating room darkness, glancing at the overhead monitors, Dr Wolf moves his hands much as he would if he were holding the actual instruments. He shows the robot how to grab a piece of flesh with the forceps and begin peeling it away from the chest wall. An hour later, several inches of the artery were dangling from the patient's chest, then are attached robotically to the beating heart,while the team waits for another instrument to stabilise the small area of the heart so they can more precisely attach the artery. Even though they finish the job by hand on the same day, there is no need for any really large incision. Instead the team will work between the ribs in a hole no wider than a tennis ball to reattach the artery some five hours later. The patient is wheeled from the operating room, and says Dr Michler, "I can tell the waiting family the good news".
Nevertheless, so far only this robotic bypass procedure has FDA approval, but trials are under way to repair the heart valves, place pacemaker wires and stabilise irregular heartbeats robotically.
Dr Michler happily repeats himself: "no question but that the future of heart surgery lies in robotics".
