Surgical procedures involve the regular change of instruments, such as graspers, scissors and needle drivers, during the operation. The world specialist in medical robotics, Computer Motion, has just obtained the issuance of a new patent which protects the fundamental concepts applied in robotically enhanced surgery. One of them constitutes the act of intra-operative surgical instrument changing, which is of vital importance in all surgical interventions performed with the ZEUS Robotic Surgical System. In endoscopic heart bypass surgery, the interchange of instruments attached to the robotic arm should be able to take place in a fast and flexible way.
The advanced robot equipment, designed by Computer Motion, consists of three different systems. The AESOP 3000 is a voice-controlled endoscope positioning tool. The HERMES Control Center forms a centralized unit, allowing the surgeon to accurately monitor via voice control an entire network of "smart" medical devices. The ZEUS Robotic Surgical System is being applied in the performance of innovative minimally invasive microsurgery operations, such as endoscopic coronary artery bypass grafting (E-CABG). In this way, the company contributes to the creation of the 21st century Intelligent Operating Room.
At present, Computer Motion is able to demonstrate the huge potential of the ZEUS Robotic Surgical System at fourteen development sites, installed all over the world. The company's proprietary computer-enhanced and robotic surgical systems definitely extend the physician's capabilities, increase the number of successful outcomes and reduce overall costs for the hospitals. It took the company nine years to develop the platform technology, utilized by ZEUS, to enable minimally invasive microsurgical procedures. The AESOP endoscope positioning system has been applied in over 50.000 operations and currently supports the ZEUS technology.
Starting with extensive inanimate, acute, chronic and cadaveric studies, the company slowly moved to clinical trials in tubal reanastomosis procedures. This type of interventions finally enabled the accomplishment of complete endoscopic cardiac procedures. Through the step-wise process of a wide range of clinical experiences, Computer Motion gained all the knowledge, essential to perform safe and repeatable endoscopic cardiac procedures with excellent results. The recent completion of a set of ZEUS cardiac cases constitutes the latest achievement in the march towards tomorrow's Intelligent Operating Theatre.
At the end of last year, the very first heart bypass surgery procedures with the ZEUS Robotic Surgical System have been performed by internationally renowned cardiac surgeons. The team comprised Ralph Damiano, MD of Hershey Medical Center in Pennsylvania, Michael Mack, MD of Medical City in Dallas, Hermann Reichenspurner, MD, Ph.D., and Bruno Reichart, MD, Ph.D., of University Hospital Grosshadern in Munich. Both operations took place in Munich and involved Left Internal Mammary Artery (LIMA) to Left Anterior Descending (LAD) coronary artery anastomoses through pencil-sized ports.
Just about a month later, the world's premier beating heart coronary artery bypass procedure was completed at Grosshadern in Munich by Professors Reichenspurner and Reichart with assistance of the voice-controlled ZEUS System. Typical for a beating heart CABG procedure is the superfluity of a cardiopulmonary bypass (CPB) with a heart-lung machine. Indeed, the heart continues to beat during the intervention, providing the patient's body with oxygenated blood. Scientific studies have proven that eliminating the CPB is likely to reduce the risk of stroke and neurological complications associated with a traditional stopped-heart procedure.
Computer Motion has demonstrated that the ZEUS Robotic Surgical System forms an ideal assistance for the surgeon in the performance of both beating and stopped heart procedures. The pioneering efforts of the fourteen initial ZEUS development sites will soon allow for truly endoscopic cardiac surgery on stopped as well as on beating hearts. For more information, please consult the VMW article on voice-controlled surgical robot assistance in minimally invasive heart surgery procedures in the March 1998 issue.