Most patients having cardiac bypass surgery, the most commonly performed heart operation, anticipate a lengthy hospital stay and recuperation period, mostly because of the need to make a large incision through the chest wall and separate a patient's rib cage in order to gain access to the heart. By using the da Vinci Robotic Surgery System, the first robotic system approved by the FDA for assisting surgery, the bypass is performed completely inside the chest wall with very small incisions.
"Robot-assisted, minimally invasive heart bypass surgery provides multiple advantages to our patients over standard techniques, including a quick return to full activity, less discomfort and less scarring", commented Dr. Gerdisch, one of an elite group of approximately 15 surgeons in the United States performing this procedure. "By reducing healing and hospital stay times, the overall cost of care will diminish as well."
Using two robotic "arms" and a camera system for three-dimensional visualization and precise instrument control, surgery is completed through three pencil-sized holes while the surgeon is seated at a control console several feet away from the patient. By using a heart stabilizer, the need to stop the heart from beating is removed, reducing the risk of stroke, memory loss and kidney complications. Like conventional cardiac bypass, a blood vessel is taken from the tissue of the chest and placed in the narrow area of the heart that restricts circulation.
While typical bypass surgery entails three or four days in the hospital, patients having this minimally-invasive approach will be able to leave the hospital earlier, have less cosmetic scarring and enjoy no restrictions, including the need to avoid driving for several weeks. "This significant milestone in minimizing the trauma of surgery, while providing the same excellent patient outcomes, illustrates that state-of-the-art technology plays a vital role in advancing cardiac surgery and thereby truly benefiting patients", explained Dr. Gerdisch.
Dr. Gerdisch performed the first case on August 24 and his 51-year-old patient was discharged August 26 in good condition. He is doing well and has resumed normal activities without any pain or complications. The da Vinci system is currently being used in abdominal, chest and prostate operations at Central DuPage Hospital (CDH). The Winfield-based hospital is a recognized pioneer and leader in minimally invasive and laparoscopic surgeries and was the first hospital in DuPage County to perform open heart surgery. CDH is ranked second in the state for surgical volumes, performing over 21.000 operations annually.
Drs. Louis Brunsting and Robert Binford successfully operated on a 66-year-old Nashvillian conducting the entire coronary artery bypass surgery procedure through ports. "With half a million Americans expected to need bypass surgery this year, this accomplishment is monumental", stated surgeon Louis Brunsting. "It means patients will have less scarring, less pain and much faster recovery times."
"For patients who undergo the procedure with the robot, it is possible that they will be home in one to three days post op and returning to normal activity in two to four weeks", continued surgeon Robert Binford, Dr. Brunsting's partner in pioneering the new technique. The da Vinci system allows the surgeon to operate through small incisions while seated at a console that displays 3D images of the surgical field through a high-powered endoscopic camera inside the patient. As the surgeon grasps the daVinci's master controls below the display, any movements of his hands, wrists and fingers are replicated in real time by tiny surgical instruments inside the patient.
Since Centennial started using the da Vinci two years ago, Drs. Brunsting and Binford have performed more than 100 cardiac-related surgeries robotically making the robotic programme at Centennial among the top five in the nation. Centennial Medical Center is one of only two hospitals in the United States operating three da Vinci surgical systems, making it the eighth busiest programme in the United States and one of only two authorized training centres for coronary bypass in the country.
The robot's maker, Intuitive Surgical Inc. of Sunnyvale, California, has installed just over 200 da Vinci systems worldwide. The da Vinci surgical system, which was approved earlier this month by the United States Food and Drug Administration for bypass surgery, has been used extensively for gall bladder, prostate and reflux disease surgeries since it went on the market in 2000.
Centennial Medical Center, part of TriStar Health System, is a 615-bed tertiary facility that has been accredited by the Joint Commission on Accreditation of Healthcare Organizations. Centennial Medical Center has been recognized as one of the country's 100 top hospitals in cardiovascular medicine, stroke service, orthopaedics, and breast cancer management.
More information about the da Vinci surgical robot system is available in the VMW June 2004 article St. John's Hospital uses da Vinci's robot-assisted surgery to fight deadly cancer