Computer-aided endoscopic cardiac procedure promoted live on the Internet to surgeons worldwide

Santa Barbara 14 December 2001Cardiac surgeon Dr. Thomas Vassiliades successfully performed a robotically assisted, endoscopic cardiac bypass surgery on a beating heart using the AESOP Robotic Endoscope Positioner, developed by Computer Motion, and a set of specially designed instruments. The procedure was broadcast live over the Internet on December 4 to an international medical audience. Over 200 surgeons, cardiologists, and other medical professionals from forty different countries viewed the two-hour surgery live and were also able to phone in questions for the surgeon during the procedure.

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The Computer Motion SOCRATES system, designed to facilitate real time surgeon collaboration and training, was used as the primary audio and video conferencing system to enable the live Web cast from Sacred Heart Hospital in Pensacola, Florida. Dr. Vassiliades is a pioneer in the new robotically assisted Endoscopic Atraumatic Coronary Artery Bypass (Endo-ACAB) technique and has performed more than 400 Endo-ACAB surgeries to date.

The 64 year-old male patient from Navarre, Florida, was awake immediately after the operation and released from the hospital two and one-half days after the surgery. The patient is reportedly recovering quickly from the bypass surgery with little or no pain and no complications. This is a significant improvement over the 5 to 7 days in the hospital and more than eight weeks of recovery required in a conventional bypass procedure. The expense and loss of human productivity during convalescence will fall sharply with the new procedure.

"The advancement of technology and techniques in heart surgery are enhancing the surgeon's ability to perform more advanced endoscopic procedures", commented Dr. Vassiliades. "We can now treat more patients with a less traumatic approach. In the last two years, the number of coronary artery disease patients we see at our practice who are candidates for minimally invasive surgery treatment, has increased three to four times, to between fifteen and twenty percent. The potential for reduction in overall cost of medical care is also increased, in terms of shorter intensive care and hospital stays, fewer repeat procedures, and less time away from work."

The new Endo-ACAB procedure is less traumatic for patients because it eliminates the two greatest sources of pain and risk of complications associated with conventional open-heart bypass surgery: the large incision through the sternum, and the use of the heart-lung machine. With the Endo-ACAB procedure, surgeons operate through a tiny two finger wide incision between the ribs instead of having to cut through the chest bone. During this nerve and cartilage sparing procedure, the heart beats normally and is not artificially re-oxygenated with the heart-lung machine.

With this approach, surgeons can provide the same long-term outcome associated with the open procedure, with significantly faster recovery times, as well as reduced post-operative pain, overall emotional trauma and anxiety, and health care costs. Patients are typically released from the hospital in an average of two days instead of the 5 to 7 days associated with the traditional open-heart procedure. People return to work and their normal activity in 2 to 3 weeks instead of 2 months. Dr. Vassiliades reports that several of his patients have returned to full activity in less than one week.

"Awareness of the improvement in quality of patient outcomes with this approach is coming to light", stated Robert W. Duggan, Computer Motion Chairman and CEO. "Over the past six months, there has been a significant increase in the number of surgeons around the world who are seeking and starting to train in the Endo-ACAB procedure. The global Web casts not only demonstrate the operative surgeons' confidence in the Endo-ACAB procedure, but they are proving to be very popular with cardiac surgeons. Dr. Vassiliades' next Web cast is set for January 24, 2001 and will be broadcast live to over five hundred surgeons attending the Cardiothoracic Techniques and Technologies Symposium in Florida", Mr. Duggan added.

Dr. Vassiliades commented: "When we can avoid the major trauma, we can not only save lives and spare our patients many risks of physical complications but also spare them risk of changes to personality, memory, and cognitive abilities associated with use of the heart-lung machine in open heart surgery." More than 1500 Endo-ACAB procedures have been performed in the world to date. Most of the procedures are performed as a single coronary vessel bypass, and cardiac surgeons expect Endo-ACAB to play a primary role in the integrated approach to the repair of multiple vessels.

Technical details about the new robotically assisted Endo-ACAB procedure using Computer Motion's AESOP and SOCRATES Robotic Systems are available in the VMW October 2001 article New endoscopic instrument kits allow atraumatic approach to coronary artery bypass procedures.


Leslie Versweyveld

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