Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Robotic surgery for young heart patients shortens hospital stay and speeds recovery, study indicates

28.01.2004


Operation time somewhat longer, but benefits seen



In the first-ever direct comparison of robot-assisted and traditional surgery for children’s heart defects, University of Michigan surgeons report that the robot’s help reduces patients’ recuperation time and surgery-related trauma and scarring, while extending the length of the operation by just over half an hour.

Their finding suggests that the minimally invasive surgical techniques made possible by the surgeon-controlled, camera-guided robot system can give the same surgical result as open-chest techniques, with less impact on the young patient’s body.


And although the study group was small, the finding demonstrates that robot-assisted surgery may be a good option for certain defects.

U-M Congenital Heart Center pediatric heart surgeons will present their results here on Jan. 28 at the annual meeting of the Society of Thoracic Surgeons, as part of a workshop for other surgeons on robot-assisted options for young heart patients.

Says surgeon Richard Ohye, M.D., "Robot-assisted surgery has already shown quite a bit of promise in the adult population, including adults who have congenital heart anomalies. But we feel from our experience that it can be used on many pediatric patients weighing more than 10 kilograms, and can reduce hospital stays, operative trauma, cosmetic impact and overall recovery time. And we found it does so with an acceptable impact on a patient’s time in the OR."

Despite the added expense of operating room time and the robot itself, Ohye feels that the machine will more than offset its costs over time by reducing the time a child spends in the hospital after surgery, the complications he or she will face during recovery, and his or her parents’ time away from work.

Ohye and U-M pediatric cardiac surgery colleagues Edward Bove, M.D. and Eric Devaney, M.D. performed the robot-assisted and open surgeries compared in the report. Ohye and Devaney began using the robot at the U-M’s C.S. Mott Children’s Hospital in November 2002, one year after the U-M Health System acquired the $1 million da Vinci robot system.

The surgeons use the robot for a small minority of the more than 900 surgical procedures they perform each year on U-M Congenital Heart Center patients, but they expect the number will grow in the future.

The system has two main components: a seven-foot-high robot with three cable-driven that hold tiny instruments and a small camera while they are inserted into the patient’s chest through small incisions, and a visualization and guidance station where the surgeon can manipulate the robot arms using three-dimensional images from the camera inside the patient.

The Congenital Heart Center surgeons share the robot with numerous other adult and pediatric surgeons at UMHS, from urologists who use it to remove prostate glands without damaging nearby nerves, to gynecologists who extract fibroids while sparing a woman’s uterus.

At the STS meeting, Ohye will show video footage of operations to divide a vascular ring -- a rare birth defect in which blood vessels surround the esophagus and trachea, reducing a child’s ability to breathe.

He will also present data on five vascular ring division patients who had a robot-assisted minimally invasive operation, and ten who had conventional open-chest surgery for the same problem. The data also include two other children who had robot-assisted surgery for other congenital heart defects -- a persistent left superior vena cava, and the placement of electrical leads for an implanted pacemaker to correct a heart rhythm irregularity.

The robot-assisted children ranged in age from 1 to 10 years, and the smallest weighed 10 kilograms, since the camera is too large to fit between the ribs of a smaller child.

The seven robot-assisted children had a median hospital stay of two days, compared with four days for children who had open-chest surgery. One patient in each group experienced a complication called a chylothorax, in which a lymphatic duct was punctured and leaked fluid into the chest cavity.

The children who had robot-assisted surgery were in the operating room for a median of 116 minutes, compared with a median of 83 minutes for the open-chest procedures. This difference was statistically significant. But Ohye feels it is not unreasonable, especially given the other positive effects of using the robot.

The U-M team is now offering robot-assisted surgery as an option to the parents of patients with vascular rings and certain other conditions, even as they plan to expand the range of procedures they perform with it.

Someday, they hope that real-time, three-dimensional images of the inside of the heart made by sound wave echos or electromagnetic devices rather than cameras will allow them to perform minimally invasive versions of procedures that involve entering the heart itself. Right now, the imaging techniques are used to aid open-chest procedures.

"In five or so years, perhaps we’ll perform most of the basic procedures with the robot’s help," Ohye predicts. "But for now, we’re starting with building the case for its safety and its cost-effectiveness, in certain types of cases. And we’re finding that parents of our patients are embracing it, and in some cases even asking for it."


The Michigan Congenital Heart Center is one of the world’s top centers for the diagnosis and treatment of heart and vascular disorders that arise during fetal development or childhood. Patients are often followed from before birth through adulthood. The MCHC takes a multidisciplinary team approach to patient care, and offers support services to help families cope. More than 900 surgical procedures, 600 heart catheterizations, and thousands of clinic visits take place at the MCHC each year. About half of the MCHC’s patients are from within Michigan, but families travel to Ann Arbor from around the country and throughout the world for treatment and surgery.

Kara Gavin | EurekAlert!
Further information:
http://www2.med.umich.edu/prmc/media/relarch.cfm

More articles from Health and Medicine:

nachricht Scientists re-create brain neurons to study obesity and personalize treatment
20.04.2018 | Cedars-Sinai Medical Center

nachricht Research offers clues for improved influenza vaccine design
09.04.2018 | NIH/National Institute of Allergy and Infectious Diseases

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Spider silk key to new bone-fixing composite

University of Connecticut researchers have created a biodegradable composite made of silk fibers that can be used to repair broken load-bearing bones without the complications sometimes presented by other materials.

Repairing major load-bearing bones such as those in the leg can be a long and uncomfortable process.

Im Focus: Writing and deleting magnets with lasers

Study published in the journal ACS Applied Materials & Interfaces is the outcome of an international effort that included teams from Dresden and Berlin in Germany, and the US.

Scientists at the Helmholtz-Zentrum Dresden-Rossendorf (HZDR) together with colleagues from the Helmholtz-Zentrum Berlin (HZB) and the University of Virginia...

Im Focus: Gamma-ray flashes from plasma filaments

Novel highly efficient and brilliant gamma-ray source: Based on model calculations, physicists of the Max PIanck Institute for Nuclear Physics in Heidelberg propose a novel method for an efficient high-brilliance gamma-ray source. A giant collimated gamma-ray pulse is generated from the interaction of a dense ultra-relativistic electron beam with a thin solid conductor. Energetic gamma-rays are copiously produced as the electron beam splits into filaments while propagating across the conductor. The resulting gamma-ray energy and flux enable novel experiments in nuclear and fundamental physics.

The typical wavelength of light interacting with an object of the microcosm scales with the size of this object. For atoms, this ranges from visible light to...

Im Focus: Basel researchers succeed in cultivating cartilage from stem cells

Stable joint cartilage can be produced from adult stem cells originating from bone marrow. This is made possible by inducing specific molecular processes occurring during embryonic cartilage formation, as researchers from the University and University Hospital of Basel report in the scientific journal PNAS.

Certain mesenchymal stem/stromal cells from the bone marrow of adults are considered extremely promising for skeletal tissue regeneration. These adult stem...

Im Focus: Like a wedge in a hinge

Researchers lay groundwork to tailor drugs for new targets in cancer therapy

In the fight against cancer, scientists are developing new drugs to hit tumor cells at so far unused weak points. Such a “sore spot” is the protein complex...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

Unique scope of UV LED technologies and applications presented in Berlin: ICULTA-2018

12.04.2018 | Event News

IWOLIA: A conference bringing together German Industrie 4.0 and French Industrie du Futur

09.04.2018 | Event News

 
Latest News

Scientists re-create brain neurons to study obesity and personalize treatment

20.04.2018 | Health and Medicine

Spider silk key to new bone-fixing composite

20.04.2018 | Materials Sciences

Clear as mud: Desiccation cracks help reveal the shape of water on Mars

20.04.2018 | Earth Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>