ORLANDO-Tiny robots that wield miniature instruments could shrink CABG access to mere puncture wounds.
The robots could also steady the surgeon’s hand and widen the limited range of motion faced in current minimally invasive surgery. Those procedures use four- to eight-inch incisions, says the Pennsylvania team, “and often cumbersome instruments.”
But the Robotically Assisted Microsurgery program doesn’t cut out the surgeon, researchers at Geisinger Health System and Penn State’s Hershey Medical Center told the American Heart Association meeting here.
In the system, surgeons sit in front of a TV monitor several feet away from the operating table, but they control every robotic movement with large handles hooked to a computer. A miniature camera inserted through one port lets the surgeon see the operative field. The camera is voice activated and coded for commands such as left and right.
The robotic arms work with doll-sized scissors, needle holders, and graspers through probes placed in two ports on either side of the camera. Needles and suture material are the same as those used in open surgery.
A microprocessor filters the surgeon’s arm motions to eliminate tremors and to translate large movements into fine movements in the patients.
So far, says Dr. Ralph Damiano, the robot has achieved patent coronary anastomoses of the internal mammary artery working through 5- to 10-mm ports in 25 isolated pig hearts. The robot averaged 30 minutes per CABG.
Once the system’s perfected, the Hershey team hopes to start initial clinical trials in patients with single-vessel disease who are on a cardiopulmonary-bypass pump. But it could be used on a beating heart too, says Dr. Damiano.
ORLANDO-Tiny robots that wield miniature instruments could shrink CABG access to mere puncture wounds.
