Report: For heart surgery, robot beats a surgeon

Robotic surgeons leave patients with fewer complications and shorter hospital stays

Worried about doctors cracking open your chest to perform critical heart bypass surgery? Would you feel any better if a robot was involved in the operation?

Well, maybe you should.

A study out of the University of Maryland School of Medicine shows that patients undergoing minimally invasive heart bypass surgery using a robot had a shorter hospital stay, a faster recovery, fewer complications and a better chance that their bypassed vessels will remain open.

It's not cheap to use a robot in an operating room, but university researchers said in a report that it's worth the expense.

Robert S. Poston, a cardiac surgeon formerly at the University of Maryland Medical Center and the lead author of the study, noted that using a surgical robot - called the DaVinci robot - adds US$8,000 to each bypass surgery. However, the shorter hospital stay, fewer needed transfusions and fewer surgical complications offset the expense of using the required extra equipment and supplies.

"These findings are significant because payers are considering linking reimbursement for coronary artery bypass surgery to patient outcomes," said Stephen T. Bartlett, professor and chairman of the Department of Surgery at the University of Maryland School of Medicine, in a statement.

Johns Hopkins Medicine defines minimally invasive heart surgery as using substantially smaller and less traumatic, incisions - only three or four inches. The da Vinci machine, built by Intuitive Surgical, is a surgical robotic system that is used in place of hand-operating instruments. A surgeon runs the robot as it operates on the patient. The surgeon sits at a console, manipulating hand controls and viewing a 3-D image of the area being operated on.

According to the report, researchers studied 100 patients who had minimally invasive coronary bypass surgery using a robot at the University of Maryland Medical Center. The technique requires no incisions except for a few small holes that are used to insert medical instruments. The cases were compared to others where an incision was made through the patient's sternum, which often is referred to as the breastbone.

Patients with the robotic surgery stayed in the hospital, on average, for four days, while patients that had traditional surgeries were hospitalized for seven days. For high-risk patients, the difference was even greater - a five-day stay compared to 12 days.

The University of Maryland noted in its report that the robot is used quite frequently for prostate surgery, its medical center is among just a few hospitals in the United States to use the robot to do heart bypass surgery on more than a single artery.

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Sharon Gaudin

Computerworld
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