November 1999, Vol. 16, No. 10 Computer Motion and ISS make news Milestones continue for robotic surgical systems November witnessed two significant announcements in the field of robotic-assisted surgery systems. Computer Motion Inc. (Santa Barbara, Calif.; www.ComputerMotion.com) announced the successful completion of the first closed-chest beating heart cardiac hybrid revascularization procedure at London Health Sciences Centre (London, Ontario; www.lhsc.on.ca). In the two-step procedure, Douglas Boyd, MD, Director of the Minimally Invasive Cardiac Surgery Program at London Health Sciences Centre, first used Computer Motion's ZEUS Robotic Surgical System to perform an endoscopic, single-vessel heart bypass surgery on a 55 year-old male patient's left anterior descending artery. The bypass was performed through four tiny ports, through which 3mm to 5mm surgical instruments were inserted, while the heart continued to beat. In the second step, William Kostuk, MD, Professor of Cardiology of the University of Western Ontario, completed an angioplasty revascularization on the patient's second occluded coronary vessel. The cardiac hybrid revascularization procedure is an integrated approach for treating multi-vessel coronary artery disease. Minimally invasive cardiac surgery is first used to treat the principal coronary artery, while interventional therapies, such as balloon angioplasty and coronary stenting, are then used to treat other blocked vessels. This operation added a new dimension to the minimally invasive approach by completing the endoscopic bypass on a beating heart, thereby avoiding the heart-lung machine to administer cardiopulmonary bypass (CPB). Studies show that eliminating CPB may reduce the risk of stroke and neurological complications associated with a stopped heart approach. "We are pleased to report that the patient heartily refused pain medication just one day after his endoscopic bypass surgery, and was discharged and able to walk out of the hospital three days after the first operation was completed. The patient is already out raking the leaves at home," stated Dr. Boyd. "The long-term benefits to the patient are significant," commented Robert W. Duggan, Chairman and CEO of Computer Motion. "The patient experienced a fraction of the pain normally associated with conventional bypass surgery, and his super-fast return to normal living is most pleasing to his family and friends. But it is also important to note the considerable economic savings to his healthcare payor, the Canadian government. Each day saved in an intensive care unit — and in this case it was a few — provides the payor a savings of approximately US$1,400." The ZEUS Robotic Surgical System consists of three interactive robotic arms placed at the operating table, a computer controller and an ergonomic surgeon console. One robotic arm is used to position the endoscope to provide visualization of the operative site while the other two robotic arms manipulate surgical instruments under the surgeon's direct control. While seated at the console, the surgeon can view the operative site in either 3-D or 2-D, depending on their preference. The surgeon controls the movements of the endoscope with simple spoken commands. Movements of the surgical instruments are controlled via handles that resemble conventional surgical instruments. The movements of the instrument handles are scaled and tremor is filtered such that the surgeon will be able to perform fully endoscopic, minimally invasive microsurgery. ISS gets go-ahead for placement of stereotactic neurological robot Integrated Surgical Systems Inc. (ISS) (Davis, Calif.; www.robodoc.com), a developer of image-directed, robotic products for neurological and orthopedic surgical applications, has reached an agreement for the placement of ISS's Frameless NeuroMate Stereotactic Robotic Assistant with The Harper Hospital. The hospital is a division of the Detroit Medical Center (DMC) (Detroit; www.dmc.org) which serves as a teaching and clinical research site for Wayne State University (Detroit ; www.wayne.edu). NeuroMate is the first robotic technology for use in stereotactic brain surgery. NeuroMate consists of a robotic arm assembly and a PC-based positioning system. The product interfaces with ISS's VoXim Surgical Planning System, as well as other popular third-party planning stations. Wayne State University and the DMC will be the first U.S. site to clinically use ISS's patented "Frameless" technology. This technology, cleared by the US FDA in July 1999, allows for greater flexibility for both patients and surgeons by decoupling the image acquisition and surgical planning from the actual procedure. This decoupling saves most hospitals over 90 minutes of valuable operating room time. Dr. Lucia Zamorano, Professor of Neurological Surgery and Radiation Oncology and Chief of the Divisions of Neuro-Oncology, Stereotaxis, Radiosurgery and Epilepsy stated, "The Frameless NeuroMate allows us to more accurately approach targets in the brain. Image-directed robotics delivers repeatability, accuracy and time savings with the net result being significant patient comfort and cost effectiveness." Commenting on her immediate plans for the NeuroMate, Dr. Zamorano stated, "My goal is to move this technology into the open neurosurgical environment, like for craniotomies for the removal of brain tumors and arteriovenous malformations, as well as the removal of tissue in epilepsy surgery. In addition, the placement of deep brain electrodes for the treatment of tremor in Parkinsons Disease, as well as the placement of radioactive seeds in Brachytherapy will exploit the NeuroMate's ability to execute multiple accurate, repeatable trajectories. This same approach has great potential in gene therapy, cell transplantation and interstitial chemotherapy." Web Site © Copyright 1999 by Lionheart Publishing, Inc. All rights reserved. Lionheart Publishing, Inc. 2555 Cumberland Parkway, Suite 299, Atlanta, GA 30339 USA Phone: 770-431-0867 | Fax: 770-432-6969 E-mail: lpi@lionhrtpub.com Web: www.lionheartpub.com Web Design by Premier Web Designs E-mail: lionwebmaster@preweb.com