Robotically Assisted Preparation of an Internal Mammary Artery for Coronary Artery Bypass Surgery

Fargo, N.D. – On Monday, Oct. 14, 2002, the nation’s first live surgical webcast of a robotically assisted heart surgery will take place at MeritCare Health System, Fargo, N.D. The webcast will be available for viewing by the public anywhere in the world. This will give the public an unprecedented, first look at robotically assisted surgery in action. (MeritCare is one of a handful of healthcare institutions in the nation to broadcast a live, surgical webcast and is the first in North Dakota, South Dakota and Minnesota.)

The surgery will be performed by MeritCare cardiovascular and thoracic surgeon Roxanne Newman, M.D., and will be broadcast live, via webcast on Oct. 14 at 5 p.m., CDT. MeritCare cardiovascular and thoracic surgeon Ajit Damle, M.D., will field questions from the public and healthcare professionals from across the nation that are submitted via an e-mail link during the live webcast.

So far, due to FDA approval requirements, MeritCare heart surgeons have only used the robot to assist with small surgical steps within larger heart procedures. The robotically assisted portion of the surgery will be the preparing of an internal mammary artery for coronary artery bypass surgery. Currently, MeritCare heart surgeons use the robot three-to-four times a week for this procedure.

About the Robot
The robot is called the da Vinci Surgical System. It is the industry leader in operative robotic surgery and the first system approved by the FDA to perform surgery. It is used in general, urologic and gynecologic surgery; most recently, it was approved for use in heart procedures. MeritCare is one of 68 medical centers across the country using the da Vinci system.

In the next few months, the FDA will likely approve robotically assisted surgery for repairing and replacing heart valves. “This is the very beginning of a new frontier,” says Dr. Newman. “We’re limited in what we can do right now because the FDA has not yet approved many applications, but that will come, and when it does we’ll be ready. The FDA wants this technology to be successful, and so do we.” In the next year, MeritCare hopes to qualify as a clinical trial center for total endoscopic cononary artery bypass – minimally invasive heart surgery. “This is our ultimate goal,” says Dr. Newman. “This is how we’re going to tremendously reduce patient recovery time.”

Developed by Intuitive Surgical of California, the da Vinci robot has two major components. One is the surgeon’s viewing and control console and monitor, which is situated a few feet from the patient, but theoretically could be miles away. The console provides the surgeon with a sharp, three-dimensional view inside the body – sharper and more magnified than it could ever be with the special magnifying glasses worn by surgeons today. At the other end of the spectrum, three robotic arms – one equipped with a tiny camera and the other two equipped with small surgical instruments – carry out the procedure through the small incisions in the patient’s chest. Sitting at the console, the surgeon guides the surgical instruments through a set of fingertip controls.

About the Procedure
Approximately 375,000 bypass surgeries are performed each year in the United States. At MeritCare, heart surgeons last year performed over 600 heart surgeries. Currently, patients undergoing coronary bypass surgery receive a 6-to-8 inch incision to open their chest cavity. In the not-too-distant future, bypass surgery will require only three half-inch incisions made between the ribs. Through these incisions, three thin robotic arms will gain access to the heart, allowing the surgeon to perform surgery without opening the chest. For patients, it can translate to a faster, easier recovery with decreased chance of infection.

 
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