Robotic heart surgery

From Chicago, Ill., at a meeting of the American Heart Association

KINDER CUTS. Robotic heart surgery leaves smaller scars than traditional open-heart surgery does. Argenziano

Surgeons in New York have used an experimental robotic system to operate on the hearts of 17 patients. The million-dollar device has three arms that hold tiny surgical instruments, as well as cameras to give the surgeons a three-dimensional view of an area of heart tissue. The technique requires only a small incision.

Rather than cutting through muscle and bone to reach the heart, the physician-researchers inserted the robotic arms through 8-to-10-millimeter-long incisions. The surgeons used the system’s instruments to repair a small opening between the two upper chambers of the patients’ hearts, which had had the defect since birth. The procedure was successful in all the patients, says Michael Argenziano of Columbia-Presbyterian Medical Center.

“Robotic heart surgery is just the next step in the progression of less-invasive heart surgery,” says Argenziano.

On average, the patients stayed in the hospital for just 3 days, which is 2 to 4 fewer days than would be expected if they had undergone traditional open-heart surgery, says Argenziano. The robotic surgery took slightly longer than open-heart surgery but was less painful and less stressful.

A German team reported using the same kind of system to perform heart-bypass surgery–replacing clogged arteries in the heart–on 50 patients through 6-to-8-centimeter incisions in the chest. Most of these patients had diabetes, but they had fewer infections and other complications than would have been expected in people with that disease who undergo bypass surgery. One person died of pneumonia 2 weeks after surgery.

“Smaller incisions mean less pain, shorter recovery time, and greater patient acceptance,” says Argenziano.


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