PATIENTS BENEFIT FROM SURGERY BY ROBO-DOCS

DR. ROCK POSITANO SPECIAL TO THE NEWS. New York Daily News. New York, N.Y.: Sep 28, 2003. pg. 24

Copyright Daily News, L.P. Sep 28, 2003

For most patients, coronary bypass surgery involves opening the chest almost from neck to bellybutton, leaving a foot-long scar, plenty of pain and a recovery period that could be three months or longer. It also involves stopping the heart during bypass.

In 2000, the latest year for which statistics were available, more than 500,000 coronary bypass procedures were performed in the United States. Now, in some cases, robots are being used to perform these surgeries, resulting in much shorter recovery periods, and hospital stays of only two days.

Dr. Joe DeRose, director of robotics at St. Luke's-Roosevelt Hospital, performed the first robotic pacemaker implant in the United States. He is also a pioneer in bloodless coronary bypass surgery.

Robotic technology uses small, precise operating instruments that simulate the motion of the human wrist. The surgeon controls the instruments at a separate operating console, viewing the operation in 3D through the console. The surgeon's hand motions are scaled through a computer interface to eliminate tremor, allowing for incredibly precise surgical maneuvers, all through tiny (8-mm.) incisions.

"We are seeing some very special results in doing things that even a few years ago people could only dream about. And, for a patient who is elderly and has heart failure with no options, using a robot can truly be a lifesaver," DeRose said.

The robotic program at St. Luke's also has seen the first robotic removal of the thymus gland for myasthenia gravis in the U.S., and the first right lower lobectomy for lung cancer in the U.S.

One of the robotics patients was an active middle-aged man who was admitted to the hospital with heart failure and found to have a severely leaky valve. DeRose wanted to avoid replacing the valve, so he chose to perform a minimally invasive repair using the robot. Three days after the procedure, the patient left the hospital; seven days later, he was able to play nine holes of golf. He was back to work and fully active four weeks later.

With another middle-aged patient who had two blocked coronary arteries, a robotic procedure resulted in the patient's returning home on the third day and going on a ski vacation with his family seven days later.

DeRose points out that robotics are changing the face of heart surgery by allowing operations on elderly patients in failing health who would not be able to tolerate the stress of invasive surgery.

DeRose estimates that about half his candidates for heart surgery are candidates for the use of the robot. But the opportunity to use robots is only going to grow. DeRose and his associate Dr. Rob Ashton have surgeons from around the world coming to St. Luke's- Roosevelt, where they are being taught to perform these complex operations.

Ashton commented, "To be able to reduce both [patients'] pain and recovery time is what medicine is all about."

Dr. Rock Positano, M.S., M.P.H., D.P.M., is on the faculty and staff of the Weill Medical College of Cornell University.