Page 243 - PDA Robotics Using Your Personal Digital Assistant to Control Your Robot

PDA 11 5/27/03 8:53 AM Page 219
Chapter 11 / Infinitely Expandable
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 demon-
strated 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 Vinci system described in
the preceding section. “Although the equipment is costly, this is defi-
nitely part of the future,” says Michael Argenziano, M.D., lead author
of the study and director of robotic cardiac surgery at Columbia-
Presbyterian. “Patients are going to insist on it despite the expense
because it’s cosmetically superior and allows for much faster recovery.
For certain procedures, like the ASD repair, it’s already proving to be
a worthy alternative to conventional surgery.”
The researchers found that robot-assisted endoscopic heart surgery
takes a little longer than the traditional technique, but that might be
attributable to the learning curve necessary to use the new approach.
The heart was stopped for 34 minutes on average, versus about 20 for
traditional surgery. The time needed on a cardiopulmonary bypass
machine was also slightly longer.
Patients in the study had no major complications. In 14 cases, imaging
tests confirmed that the defect had been successfully closed. One
patient required a repair five days later. Surgeons did this through a
three-inch incision (a mini-thoracotomy). The average length of stay in
the intensive careunit was 18 hours, which is about the same as for the
traditional approach. The average hospital stay was three days—two
to four days shorter than for a traditional operation.

“The primary advantages of this minimally invasive surgery are faster
patient recovery, less pain, and dramatically less scarring than tradi-
tional open-heart surgery,” Argenziano says. Patients return to work
and normal activity about 50 percent faster than those who have the
open procedure, he says. Quality-of-life measures also revealed the
robotically treated patients had improved social functioning and less
pain compared to patients undergoing traditional surgical approaches.
Doctors are also using the robotic technology to repair mitral valve
defects through incisions in the side of the chest.
“What makes the totally endoscopic ASD repair a significant advance is
that it is the first closed-chest open-heart procedure,” Argenziano says.

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