Washington University heart surgeons at Barnes-Jewish Hospital have pioneered a way to make bypass surgery easier on patients.
“Traditional bypass surgery is a major operation,” says Ralph J. Damiano, MD, chief of cardiac surgery. “It includes a large incision to allow us to divide the breast bone and use of the heart-lung machine. Patients typically take four to eight weeks to recover after heart surgery.”
But a less invasive endoscopic technique is changing the face of cardiac surgery. This technique allows physicians to insert an endoscopic camera and surgical instruments through pencil-size openings in the patient's skin.
To perform endoscopic bypass surgery, the surgeon sits at a computer console that displays the surgical field. The surgeon holds handles that look just like regular surgical instruments. The surgeon's delicate motions are mechanically relayed to a computer control system - this is known colloquially as the Robot.
The surgeon’s movement is digitized and the digital information is then filtered to remove all tremors. This information is then used to control two robotic arms attached to the operating room table. These arms hold the surgical instruments that enter the patient through the pencil-sized ports.
“These robotic surgical systems have made endoscopic coronary artery bypass grafts possible,” says Dr. Damiano, who is a national leader in the introduction of robotically assisted surgery.
In 1998, Dr. Damiano became the first person to perform endoscopic bypass surgery in North America. Since he brought his team to Washington University, it is now the lead institution in the world’s first randomized trial of these robotic techniques.
Currently, endoscopic bypass surgery is only available for patients who need a single bypass (one artery to repair) , but within several years Dr. Damiano expects the surgery to be available to other heart patients. “Our goal with this surgery is to decrease pain and suffering for our patients,” he says. “The benefit of this surgery is that it only produces very small incisions and we don’t have to divide the chest bone. That means there is less post-operative pain and the hospital stay may be shorter. We expect patients may be back to work after just two weeks versus four to eight weeks after traditional bypass surgery.”
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