Thursday, April 17, 2008

Can The Robot Do The Heart Bypass Surgery?

In conventional heart bypass surgery, a patient will have to go through his or her most painful experience because his or her breastbone has to be sawn open. In addition, there will be a long zipper scar on the chest.

However, Smith (not his real name), who had a heart bypass in July 2007, does not have the long scar. Instead, there are only two 2cm long and a 5cm long scars. This is because his surgeons at the National Heart Centre (NHC) in Singapore used a robot to perform minimally invasive 'keyhole' surgery. His doctor also operated while his heart was beating. A retired teacher with an age of 80 years old, Smith went home after 5 days in hospital. He felt so lucky and claimed that there was not any pain after the operation.

The robot used in the surgery is called the da Vinci surgical system. It allows heart surgeons in Singapore to perform heart bypass, repair heart valves and remove chest tumors in a minimally invasive way. In fact, the robot has also been used for prostate surgery in Singapore since 2003.

As the robotic heart procedures are still new, doctors use them only on patients whose conditions are not complicated and who agree to the procedures.

Smith also puzzled when his doctor sought his agreement on the robotic procedure. He finally agreed only after the doctor reassured him that he actually controls the robot and that he had operated on 4 patients successfully.

The aim of the robotic procedure is bring less pain, less blood loss and faster recovery for patients. Most patients in United States are discharged 2 to 3 days after the operation, as compared to conventional bypass patients of 6 or 7 days in hospital. Nevertheless, patients in Singapore are normally discharged after 4 to 6 days, as the doctors want to be careful.

Conventional bypass surgery requires surgeons to open up the chest to reach the heart. Patients are then connected to a heart-lung machine that takes over the functions of those organs, and the heart is stopped. A vein, removed earlier from the patient’s thigh or chest, is attached to the heart arteries to create a bypass to re-channel blood away from blockages.

In a robotic procedure, it is not necessary for the surgeon to cut open the chest because the robot's arms can enter the patient’s body through small cuts and do the job within the chest. The main surgeon just needs to sit at a console to control the robotic arms to get the job done.

The robotic procedures usually cost about 10 to 20 percent more than that of the conventional heart bypass surgery. But if it can do a better job for the patients, why not?

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