Heart by-pass ops by robots

by INDIRA DAS-GUPTA , Evening Standard

Doctors at a London hospital are to perform the first heart by-pass operation in this country using robot surgeons.

The pioneering technique, which is destined to release heart patients from hospital after a matter of days instead of weeks, could slash waiting lists.

St Mary's, Paddington, has virtual surgery simulators installed and has been training its specialist surgeons in a joint project with Imperial College in preparation for the start of operations in July, using the robotic unit, known as the da Vinci Surgical System.

Because of its 'minimally invasive' surgery, the system potentially reduces recovery time for heart patients from three months to around 10 days and is likely to revolutionise the way in which operations are performed.

The St Mary's team has already used the robotic system to carry out six successful bowel operations. Now they are planning to carry out a coronary artery by-pass this year.

Professor Ara Darzi, professor of surgery at Imperial College and a consultant surgeon at St Mary's, is heading the medical side of the project. He has used the da Vinci system himself to complete the six operations successfully.

He said: 'It is one of the most exciting developments in medical technology in the past two decades and will completely change the way surgery is performed over the next few years.

'Although it has been used mainly in bowel operations at St Mary's so far, we expect to perform the first robot-aided heart operation in this country, some time this year.'

There are two parts to the system: the 'station' where the surgeon sits and watches the operation on a television screen, with three-dimensional high-definition views, and the 'slave' (the robot) which is attached to the patient and has three mechanical arms.

One arm carries a miniature light and camera while the two others have tiny metal fingers for holding scalpels and needles and are designed to mimic the motion of the human wrist.

The surgeon controls the arms by using joysticks based at the 'station' and has a magnified view of events on screen.

The computer, which is no more powerful than a reasonably large home PC, filters out the inevitable hand tremors that even leading surgeons suffer from time to time.

The entire system, which has been pioneered in America, is estimated at around £750,000, including maintenance costs. The technology will see surgeons taken off the front line, allowing them to sit at a console a few feet away instead of hovering over the patient.

It is also expected to slash hospital waiting lists by allowing surgeons to carry out operations through a centimetre-long hole in the patient's chest, thus greatly reducing the need to cut into tissue and minimising post-operative pain and recuperative time.

Full recovery from heart surgery can take three months and leaves a scar from neck to navel. Some patients also suffer depression and memory loss. Using the da Vinci system, patients could be back at work within 10 days.

Professor Darzi predicts the new system will vastly improve the work of surgeons. He says: 'The robot is a tool which enhances the ability of the surgeon. The surgeon is still in full control, but it allows him or her to perform certain keyhole operations that would otherwise be impossible. It also ensures that their work is much more precise.'

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