July 12, 1999 COLUMBUS, Ohio -- For the first time in this country, heart surgeons here will soon use new computer-enhanced robotic technology to improve heart bypass surgery, limiting patients' pain and the healing time normally associated with these procedures.
The new technique, recently begun in Europe, may be used on the first American patient as early as this summer. Ohio State is the first of a handful of medical centers expected to begin using the equipment in the next year.
University physicians joined officials from Intuitive Surgery, Inc., manufacturer of the da Vinci Computer-Enhanced Surgical System, in announcing a partnership Wednesday (6/30) at the Columbus campus. Ohio State is expected to pay $1 million for the equipment and will be the site of the first Food and Drug Administration-approved American clinical trial using this device.
Physicians have used endoscopy and laparoscopy for years as a way of reducing the invasive nature of certain surgical procedures. But some surgeries were considered too complex or risky for this approach, explained Pascal Goldschmidt, professor of cardiology and director of Ohio State's Heart and Lung Institute.
"Physicians were reluctant to use this approach when the risk of bleeding was high," Goldschmidt said.
This new system, however, combines the use of two new technologies -- computer-enhanced visualization and advanced articulated robotics -- to reduce the trauma to patients during heart surgery which, in turn, should speed their healing. In conventional heart surgery, physicians have to divide the sternum and separate the ribs to access the heart. This new process allows small, pencil-sized, articulated robot arms to be inserted through one-inch slits in the chest. The arms then manipulate various surgical instruments inside of the closed chest, reducing the trauma to the patient.
The surgeon controls the arms and their instruments while peering through a computer console. Video cameras mounted in a third arm provide a three-dimensional, magnified view of the surgical site. In essence, the physician performs 'virtual' surgery on the patient and the robotic arms mimick every single one of the surgeon's movements with amazing precision inside the 'real' patient.
"It's important to remember that the surgeon is still the one who is doing the procedure and the one who is in control," explained Randall Wolf, a cardiac surgeon from Christ Hospital in Cincinnati. Wolf, who has trained in Europe using this equipment, will join the Ohio State faculty in August.
"This is a tremendous advancement in minimally invasive surgery that is aimed at improving the quality of life for patients," he said.
Later this summer, Ohio State's Medical Center will begin the first clinical trial using the technology on patients requiring a single vessel coronary bypass. Sixty patients are expected to be enrolled in the trial.
"This approach offers significant advantages to cardiac patients," said Robert Michler, chief of cardiothoracic surgery at Ohio State. Michler received training in Europe using the new system earlier this year.
"Eventually, we expect to see a heart patient receive surgery one week and then return to work the next," he said.
Approximately 50 cardiac procedures using this technology have been successfully conducted in Europe in the past several months. The technology has also been used for various non-cardiac surgical procedures as well.
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