First Robotically-Assisted Heart Bypass Surgery Successfully Performed In United States

December 09, 1998

Hershey, Pa. --- A Penn State College of Medicine researcher yesterday performed the first robotically-assisted heart bypass surgery on a 70-year-old female patient at the Penn State Geisinger's Milton S. Hershey Medical Center. The patient is stable today and is recovering as expected.

The procedure was performed as part of a U.S. Food and Drug Administration (FDA) approved Investigational Device Exemption (IDE) Phase 1, 10-patient study using the ZEUS TM Robotic Surgical System.

Ralph J. Damiano Jr., M.D., chief of cardiac surgery and professor of surgery and cellular and molecular physiology, completed the procedure using the ZEUS Robotic Surgical System. The operation took about four hours to complete.

This procedure marked the first use in the United States of a robotic system to assist in heart surgery. The ZEUS system enabled the surgeon to perform delicate and critical suturing on the heart through tiny ports, a technique not possible with conventional open-heart surgery.

Damiano said, "We have been working with the ZEUS system here at Hershey Medical Center for nearly two years and have completed both acute and chronic animal studies. This procedure was the appropriate next step for our clinical team in using the ZEUS System to develop safe, effective and reproducible closed-chest procedures for the heart. In the near future, we should be able to perform completely closed-chest heart bypass surgery, making cardiac surgery even less invasive. "

He will perform this procedure a total of ten times over the next 30 to 60 days at Hershey Medical Center.

In conventional open-heart surgery, a 12 to 15 inch incision is required to split a patient's breast bone to provide a surgeon direct access to the heart. Computer Motion's ZEUS Robotic Surgical System is designed to enable a surgeon to perform the delicate maneuvers necessary to suture the tiny vessels in heart bypass surgery through small pencil-sized ports. Visualization is provided by a small camera that is inserted into the chest through a tiny port and is held by a voice-controlled robotic arm. Eliminating the large incision would provide the benefits of significantly reduced patient pain and trauma, shorter recovery times and convalescent periods, and overall improved outcome.

Computer Motion's ZEUS Robotic Surgical System consists of three interactive robotic arms placed at the operating table, a computer controller and an ergonomic surgeon console. One robotic arm is used to position the endoscope (a special, slender camera) while the other two robotic arms manipulate surgical instruments under the surgeon's direct control.

While seated at the console, the surgeon can view the operative site in either 3-D or 2-D, depending on their preference. The surgeon controls the movements of the endoscope with simple spoken commands. Movements of the surgical instruments are controlled via handles that resemble conventional surgical instruments. The movements of the instrument handles are scaled and tremor is filtered such that the surgeon will be able to perform fully endoscopic, minimally invasive microsurgery.

In the United States alone, more than 450,000 open-heart surgeries are performed annually, the vast majority of which currently require the full 12-to-15-inch breastbone incision.

Yulun Wang, Ph.D., founder of Computer Motion, said, "A completely closed-chest approach to heart bypass surgery has not been possible because the delicate task of suturing a bypass-graft to a coronary artery through small incisions is beyond human capabilities. The ZEUS Robotic Surgical System enhances a surgeon's hands much like a microscope enhances a surgeon's eyes. This 'enhancement' gives the surgeon the extra precision and dexterity necessary to perform these very delicate procedures without having to crack the patient's chest wide open. We are very pleased that the FDA has examined our clinical data to date, and has allowed us to move forward to prove the merits of this concept."
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Penn State

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