September 13,
2002
Complete Robotic Heart By-Pass Surgery,
Soon to Start at HUP, Promises Dramatic Patient Benefits
Million-Dollar System Expands the Scope of Minimally
Invasive Surgery, Reducing Post-Operative Pain and Recovery
Periods for Patients
(Philadelphia, PA) -- Remote-control surgery, one of
the major advances of 21st Century medicine, is now
being performed at the Hospital of the University of
Pennsylvania (HUP), using the hospital's newly acquired,
$1 million robotic system.
Designed to afford unprecedented precision and dramatically
reduce the physical trauma and recovery time of traditional
surgery, the daVinci Surgical System (manufactured by
Intuitive Surgical of Sunnyvale, CA), is the first robotic
system to receive approval by the U.S. Food and Drug
Administration for use in American operating rooms.
"We are providing our outstanding surgeons with a state-of-the-art
robotic system that is designed to streamline their
demanding and meticulous work and at the same time to
enhance our already outstanding patient care and treatment,"
said James L. Mullen, MD, Associate Executive Director
of HUP.
The daVinci system is now cleared by the FDA for laparoscopic,
thoracoscopic and radical prostatectomy procedures,
and is FDA-approved for clinical trials that include
traditional open-heart cardiac procedures such as mitral
valve repairs and atrial septal defect repairs.
HUP has been invited to take part in a new FDA study
designed to establish the benefits of fully robotic
coronary artery bypass grafting (CABG) surgery. "We
are pleased to be part of this landmark work, which
ushers in a new era in cardiothoracic surgery," said
Timothy J. Gardner, MD, Chief of Cardiothoracic Surgery
at HUP. Y. Joseph Woo, MD, HUP's newly appointed Director
of Minimally Invasive and Robotic Cardiac Surgery, will
perform Philadelphia's first completely robotic coronary
artery bypass grafting procedure. "This technology will
eventually provide surgical opportunities that we have
not even imagined yet," said Woo. "It transports the
surgeon's hands and eyes directly inside the patient's
chest and heart. We now have a view of the heart that
surgeons have never had before."
Named for the Renaissance painter and inventor Leonard
daVinci, who once sketched plans for a mechanical robot,
the self-contained daVinci robotic system has three
main components: a mechanical robot with three multi-jointed
arms; a computer command center several feet from the
patient, where the doctor sits, and a 3-D computer monitor
similar to a "viewfinder" that affords a magnified view
of the surgical site inside the patient.
Equipped with a special, double-telescopic endoscope,
the viewfinder allows surgeons to see the surgical site
more closely than human vision allows, and to work at
a smaller scale of detail than conventional surgery
permits. Unlike other endoscopic systems now in use,
which afford reverse-image views that require counter-intuitive
movements by surgeons (whereby the surgeon must move
his hand to the left in order to move the mechanical
device to the right), the daVinci technology affords
surgeons the direct, "intuitive" control they exercise
in traditional open surgical procedures, seamlessly
translating their natural hand, wrist and finger movements
at the console into corresponding micro-movements of
laparoscopic surgical instruments inside the patient's
body.
In cardiac surgery, this technique will eliminate the
traditional six -to-ten-inch surgical incision and the
practice of spreading apart the patient's ribs (which
sometimes crack) in order to gain access to the heart.
Instead, each mechanical arm enters the chest cavity
through an incision the length of a small button-hole,
minimizing tissue and nerve damage, and avoiding the
risk of extensive damage to the ribcage.
The robotic procedure reduces post-operative pain and
surgical complications for patients, shortening hospital
stays and dramatically reducing the length of time necessary
for full recovery. (An article this year in Popular
Science magazine noted that some doctors involved in
the cardiac surgery trials think patient recovery time
could be reduced from three months to 24 hours.)
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