And, according to a University of Maryland study, robotic heart bypass surgery also makes good economic sense for hospitals. The study will be presented at the American Surgical Association on April 26, 2008.
Using a surgical robot increases the cost of each bypass case by about $8,000, according to Robert S. Poston, M.D., a cardiac surgeon formerly at the University of Maryland Medical Center who is the lead author of the study. He says those additional expenses, which are due to equipment and supplies, are offset by a shorter hospital stay, reduced need for transfusions and fewer post-surgical complications that would require a patient to be re-admitted to the hospital. Especially with high risk patients who have lung or kidney disease or other health problems, the researchers found that the minimally invasive, robotic approach saves costs.
“These findings are significant because payers are considering linking reimbursement for coronary artery bypass surgery to patient outcomes,” says Stephen T. Bartlett, M.D., professor and chairman of the Department of Surgery at the University of Maryland School of Medicine and chief of surgery at the University of Maryland Medical Center.
“Our study shows that there are health benefits to patients from the minimally invasive approach, both in terms of a shorter recovery and also looking at the function of the bypass graft months after the surgery,” adds Dr. Bartlett, who is one of the study’s co-authors.
While the DaVinci surgical robot is in widespread use for prostate surgery, the University of Maryland Medical Center is among only a few hospitals nationwide, and was one of the first in the U.S., to use the robot to perform multiple vessel heart bypass surgery.
The researchers studied 100 consecutive 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 to insert instruments. These cases were compared to a matched group of 100 patients who had the traditional “open” bypass surgery with a sternotomy, a surgical incision through the sternum.
The average length of the hospital stay for the patients with the minimally invasive surgery was about four days compared to seven days for the traditional bypass operation; however the difference was even greater among patients considered to be at high risk. In that group, the average stay was five days with robotic surgery compared to 12 days with the traditional technique.
The complication rate for those who had the robotic bypass was also much lower, with 88 percent of patients free of complications after having the minimally invasive surgery compared to 66 percent of those with the “open” operation.
The patients in the study were followed up one year after their surgery. Using a CT angiography scan, the researchers found that those who had the robotic bypass were much less likely to have narrowing or clots in the bypass graft than those with the traditional bypass surgery from six months to a year after the operation.
“We saw a long term benefit to patients after their bypass in terms of the patency, or openness, of the bypass graft, according to Bartley Griffith, M.D., head of Cardiac Surgery at the University of Maryland Medical Center and professor of surgery at the University of Maryland School of Medicine. Dr. Griffith, also a co-author of the study, says the grafted vessels of more than 99 percent of the patients who had robotically-assisted bypass surgery were still open and functioning well compared to about 80 percent of those who had the “open” operation.
The reason for the difference is that for patients who need multiple bypasses, surgeons can easily access two internal mammary arteries to use as the new bypass vessels rather than taking a section of vein from another part of the body. In traditional bypass operations, only one internal mammary artery is used while other bypasses are performed using a vein. The long-term success of the bypass, or patency of the target vessel, is superior with an internal mammary artery versus a vein.
Dr. Poston says hospitals have been waiting for data on the costs and benefits of robotic-assisted heart bypass programs before investing in them. “Our conclusion from this study is that robotically-assisted coronary artery revascularization presents quality of life benefits for patients along with financial savings for those hospitals which care for large numbers of high risk patients,” says Dr. Poston, who recently moved from the University of Maryland to be the chief of cardiac surgery at Boston Medical Center.
The study, “Superior Financial and Quality Metrics with Robotically-assisted (DaVinci) Coronary Artery Revascularization,” will be presented at the 128th annual meeting of the American Surgical Association in New York on April 26, 2008.
Ellen Beth Levitt | EurekAlert!
Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University
New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg
Satellites in near-Earth orbit are at risk due to the steady increase in space debris. But their mission in the areas of telecommunications, navigation or weather forecasts is essential for society. Fraunhofer FHR therefore develops radar-based systems which allow the detection, tracking and cataloging of even the smallest particles of debris. Satellite operators who have access to our data are in a better position to plan evasive maneuvers and prevent destructive collisions. From April, 25-29 2018, Fraunhofer FHR and its partners will exhibit the complementary radar systems TIRA and GESTRA as well as the latest radar techniques for space observation across three stands at the ILA Berlin.
The "traffic situation" in space is very tense: the Earth is currently being orbited not only by countless satellites but also by a large volume of space...
An international team of researchers has discovered a new anti-cancer protein. The protein, called LHPP, prevents the uncontrolled proliferation of cancer cells in the liver. The researchers led by Prof. Michael N. Hall from the Biozentrum, University of Basel, report in “Nature” that LHPP can also serve as a biomarker for the diagnosis and prognosis of liver cancer.
The incidence of liver cancer, also known as hepatocellular carcinoma, is steadily increasing. In the last twenty years, the number of cases has almost doubled...
In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.
Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...
Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.
They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...
A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...
23.03.2018 | Event News
19.03.2018 | Event News
16.03.2018 | Event News
23.03.2018 | Materials Sciences
23.03.2018 | Agricultural and Forestry Science
23.03.2018 | Physics and Astronomy