Open-Heart Surgery Without Opening the Chest
Nov 19, 2002
Columbia University Medical Center at NewYork-Presbyterian Hospital today released the initial findings of a study to investigate the benefits of robotic open-heart surgery for correcting atrial septal defect (ASD). In July 2001, using a surgical robot, Columbia University Medical Center performed the first open-heart surgery without opening the chest to repair the defect. Since then, 17 patients have received the procedure for this defect. The findings were presented today at the American Heart Association's Scientific Sessions in Chicago.
Preliminary results point to improvements in recovery time and quality of life, said the study's lead author Dr. Michael Argenziano, director of robotic cardiac surgery at Columbia University Medical Center and assistant professor of surgery at Columbia University College of Physicians & Surgeons. "We've seen dramatic improvements in hospital stay and recovery time. Also, patients experienced comparatively improved social functions and less pain postoperatively."
In the procedure, the surgeon controls robotic arms from a viewing console located several feet away from the patient. Instead of making a large incision, the robot's instruments and camera are inserted through four small holes in the patient's chest. The robot used in the procedures, called the Intuitive Surgical da Vinci™ Surgical System, has Food and Drug Administration approval for a number of clinical trials in heart surgery.
Individuals with ASD are born with an abnormal opening between the two upper chambers of their heart. Untreated, ASD can result in pulmonary hypertension, congestive heart failure, atrial arrhythmias and an increased risk of stroke. The condition is present in four out of 100,000 people.
Preliminary findings show that on average, patients who had the robotic procedure stayed in the hospital two to four days shorter and returned to work 50 percent faster than those who have the open procedure.
The robotic procedure time was shown to be slightly longer than the open procedure, but this may be attributable to the learning curve necessary to use the device. The heart was stopped for 34 minutes on average, versus about 20 for traditional surgery.
The 17 patients in the study had no cardiac complications. In 16 cases (94 percent), imaging tests confirmed that the defect had been successfully closed. One patient required a repair five days later.
Columbia University Medical Center is the only institution in the world participating in three FDA trials of robotic heart surgery and serves as a national training center. Earlier this year, Dr. Argenziano as lead investigator, performed the first robot-assisted, closed chest coronary artery bypass surgery in the United States. The third trial being conducted at Columbia University Medical Center is totally endoscopic atrial fibrillation (heart arrhythmia) surgery.
The study's co-authors are: Dr. Mehmet C. Oz, Dr. Takushi Kohmoto, Dr. Mauricio Garrido, Jaina Dimitui, James Back, Linda Mongero, Hadar Hermoni, and Dr. Craig Smith.