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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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