Small incisions, big results with Intuitive Surgical's da Vinci system

Mountain View 10 September 1999The da Vinci Surgical System, developed by Intuitive Surgical, the California-based world leader in computer-enhanced surgical systems, has proven its excellent performance in two European hospitals during the past summer. At San Matteo Hospital in Pavia, Italy, a fully endoscopic, closed-chest cardiac surgical procedure was successfully performed in July. In the Department of Thoracic and Cardiovascular Surgery at the Johann-Wolfgang von Goethe University Hospital in Frankfurt, Germany, the world's very first closed-chest Atrial-Septal Defect (ASD) closure took place on August 24th 1999.

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The San Matteo Hospital in Pavia constitutes Intuitive Surgical's fifth Europen centre to complete a cardiac bypass surgery through three incisions of barely 1 centimetre. The da Vinci Surgical System was installed at this leading Italian cardiac surgical centre in July 1999. Within one week of receiving the system, Professor Vigano, Dr. Rinaldi, and the surgical team, were able to successfully perform a fully endoscopic, closed-chest cardiac surgical procedure. Professor Mario Vigano is head of the Cardiac Surgery, and his assistant, Dr. Mauro Rinaldi, is a cardiac surgeon and a research scientist at the San Matteo Hospital at the University of Pavia.

Professor Vigano stated that the surgeons are very pleased to have the da Vinci Surgical System implemented at the hospital. The team is also excited about the clinical achievements realized within a short period of time. The system performance has been excellent while surgical procedures feel very natural, even though Professor Vigano has never operated completely closed-chest on a patient before. The surgeons were able to use endoscopic access to do the same operation as performed in traditional surgery, and avoid the side effects of the typical 30 cm incision.

Within 24 hours after the surgery, the patient was able to walk from the Intensive Care Unit to the recovery room with little to no pain, according to Dr. Rinaldi. The post-operative examination revealed that the patient was progressing well, and he was released from the Intensive Care Unit after 12 hours. The patient left the hospital over the weekend and was already able to join his family for a previously scheduled August vacation, as Dr. Rinaldo reports.

Proctoring the San Matteo surgical team was Dr. Romuald Cichon, from the Herz-Und Kreislaufzentrum Dresden. Dr. Cichon has personally performed over 35 coronary cases using the da Vinci Surgical System since Dresden's acquisition of a system in early May of this year. Professor Vigano further mentioned that he is confident that Italian patients will benefit from this new technology by receiving a superior operation, as well as gaining the rewards of smaller incisions, less pain, and faster recovery times.

Although the team is still in the initial stages of performing single vessel cardiac procedures endoscopically, with the continued use of this system, fully endoscopic, multi-vessel procedures are inevitable. About a month later, another team of this time German surgeons in the Department of Thoracic and Cardiovascular Surgery at the Johann-Wolfgang von Goethe University Hospital in Frankfurt, successfully completed the world's first closed-chest Atrial-Septal Defect (ASD) closure, which was totally endoscopic through three ports of 1 cm.

Using Intuitive Surgical's da Vinci Surgical System, the surgeons actually perform procedures seated at the console, while viewing a high-resolution 3-D image of the surgical field. The surgeon's hands rest below the monitor and hold instruments which provide the flexibility of those that are used in open surgery. Specialised technology simultaneously transfers the surgeon's exact hand movements made at the console to the extremely precise micro-surgical movements of the instruments at the operative site. Please, find out more about these innovative surgery methods in the VMW article European surgeons to experiment with minimally invasive procedures in the August 1998 issue.


Leslie Versweyveld

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