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Division of
Cardiovascular Surgery
Minimally Invasive and Robotic Cardiac Surgery

Widespread acceptance of laparoscopic cholecystectomy by patients and physicians in the late 1980’s and early 1990’s brought about an explosive growth in minimally invasive surgical approaches to common general surgical, urologic, and gynecologic procedures. This was matched by a rapid development of minimally invasive techniques in thoracic surgery. Robotics SurgeryMany of these approaches have been shown to improve patient outcomes and satisfaction as well as shortening hospitalizations. Technical limitations of endoscopic equipment have precluded the wide spread application of minimally invasive approaches to cardiac surgery. The overwhelming majority of cardiac operations necessitate opening the chest through a large midline sternotomy incision. Given that cardiovascular disease is both the leading cause of mortality and the leading diagnosis for hospital admission in the United States and that each year, well over 500,000 patients undergo cardiac surgical procedures, there has been a very aggressive pursuit for technology to facilitate minimally invasive cardiac surgery.

During the past few years several technologic advancements in cardiac surgery have emerged to facilitate minimally invasive cardiac surgery. These include the use on non-sternotomy minimal access incisions on the side of the chest to perform valvular reconstructions and beating heart surgery which avoids the adverse effects of the cardiopulmonary bypass machine. At Penn we perform hundreds of minimally invasive cardiac surgery procedures annually. We have an extensive experience going back many years and our surgeons have written many landmark articles in this field.

Robotics SurgeryAnother major revolutionary breakthrough in the field of minimally invasive cardiac surgery occurred with the development of computer assisted robotic surgical systems which integrate three dimensional optics that immerse the surgeon in the operative field together with sleek, small-caliber, multi-jointed surgical instruments that precisely replicate the surgeon’s wrist and hand movements. Thus, by effectively transporting the surgeon’s eyes and hands into the patient’s chest, one can perform an entire operation without opening the chest. The tiny incisions used for access to the heart cause minimal trauma and result in decreased blood loss, less pain and lower risk of infections. These translate into shorter ICU stays, shorter hospitalizations, faster recovery, improved cosmesis, improved patient outcomes and increased patient satisfaction.

Penn was one of only twelve heart surgery centers nationwide and the only one in the Philadelphia region invited to participate in the first US clinical trial on total robotic coronary artery bypass grafting. We have since greatly expanded our applications for robotic cardiac surgery and are performing valvular reconstruction, atrial septal defect closure, and coronary artery bypass grafting. To date nearly 100 robotic cardiac surgery operations have been performed at Penn. Again our surgeons have written many of the articles in this field and are involved in the advancement of this specialty, developing newer and even less invasive operations.

We are currently actively engaged in robotic surgical training for this trial. Future applications in cardiac surgery include arrhythmia ablation, transmyocardial laser revascularization, and heart failure therapy. Aside from cardiac surgery, multiple general surgical, urologic, and gynecologic robotic applications are already widely practiced. Many feel that robotic minimally invasive surgery will eventually be applied to vascular, orthopedic, spinal, neurologic, pediatric and other surgical disciplines. Robotic systems foster innovation and promote the development of new approaches to existing operations as well as the invention of completely new operations. In the future, molecular and genetic strategies for treating diseases may be facilitated with minimally invasive robotically delivered vectors.

To provide a comprehensive program for patients coming to Penn, a Minimally Invasive and Robotic Cardiac Surgery Program has been formed. The availability to provide robotic cardiac surgery will generate increased patient referrals, admissions and revenue as well as enhanced community and media awareness. Currently, in the Philadelphia region, there are no robotic cardiac surgical programs, with New York City providing the nearest alternative. Regional leadership is attainable and national leadership will be a goal of this program.

Inpatient Facilities:
Hospital University of Pennsylvania (HUP)
Penn Presbyterian Medical Center (PPMC)
Mercy Fitzgerald Hospital (MFH)
Office Visit Locations:
Perelman Center - East Pavilion, 2nd Floor (HUP)
266 Wright-Saunders Building (PPMC)
1501 Lansdowne Avenue (MFH)
Making an Office Visit Appointment:
215-615-4949 or 800-789-PENN
Pavan Atluri
P. Atluri
Clark Hargrove
C. Hargrove
Hans Haupt
H. Haupt
Wilson Szeto
W. Szeto
Steven Weiss
S. Weiss

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