Pioneering Heart Surgery

Heart surgery is typically painful for the patient, involving a 12-inch incision and the opening of a rib cage.

But doctors at East Carolina University's School of Medicine say a robot will allow them to operate without opening the chest cavity, resulting in shorter hospital stays, less pain and a quicker recovery.

"We'll be able to perform operations with this surgical device that have never been imagined previously," said Dr. Randolph Chitwood, director of the University Health Systems Heart Center and an internationally recognized leader in minimally invasive heart surgery.

ECU's School of Medicine was one of two sites nationally to receive a da Vinci Surgical System, which will allow them to perform this country's first trials of heart surgery with a robot. Engineers installed the system Monday in the School of Medicine's Life Sciences Building. The Ohio State University Medical Center, the other site to install da Vinci in the United States, will focus on bypass surgeries.

"I think it's another step in the evolution of what we want to accomplish here at the medical school," said Dr. Wiley Nifong, a cardiothoracic surgeon. "Our goal is to be a robotic training center. It helps to move our heart center and hospital further up the scale."

The minimally invasive system has two main parts: the surgeon's master control console and a unit that positions and maneuvers surgical equipment.

Three robotic arms, controlled by surgeons, guide a tiny camera, scalpels, needles and other sterile instruments into a patient's chest through dime-size incisions.

The arms' computerized mechanical "wrists" mimic the dexterity of the surgeon's forearms and hands, performing the incisions and stitches he or she would have to make manually in open-heart surgery.

The camera projects three-dimensional images onto a monitor in front of the surgeon to view his work. "With this system, we are miniaturizing the surgeon and placing him inside the heart," Chitwood said.

Intuitive Surgical created and shipped the da Vinci system from Mountain View, Calif.

The medical school and its affiliated teaching hospital will be a national testing site for the $1 million system. Greenville surgeons will focus on repairing or replacing defective mitral valves.

ECU is awaiting approval, expected after January, from the U.S. Food and Drug Administration to begin the clinical trials on people. In the meantime, surgeons will operate on cadavers and pig hearts, Nifong said.

The da Vinci system is approved for human use in Europe. More than 100 cardiac procedures and 150 general surgeries have been performed around the world using the da Vinci system, officials said.

In February, Chitwood became the first American to perform a mitral valve repair using the da Vinci system in Leipzig, Germany. He will return to Germany with medical school colleagues later this week to tach seminars on surgical robotics.