State's First Robot-assisted Surgery

Contact: Jill Holder

Photo of robotic-assisted surgery at UK Hospital
(click photo to enlarge)
A robotic-assisted surgical procedure being performed.

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Traditionally, heart bypass surgeries require a large 8- to 10-inch incision through the chest wall. The robotic system at UK allows surgeons to insert instruments through tiny ports, placed within one-centimeter incisions in the body. Surgical procedures using the robotic system require a minimum of three incisions; one for a camera and two for surgical instruments. Surgeons can rotate the instruments 360 degrees through the incisions.

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LEXINGTON, Ky. (Feb. 13, 2004) -- University of Kentucky Hospital announced today the state’s first surgical procedure utilizing robotic instruments. Chand Ramaiah, M.D., assistant professor of surgery and director, Minimally Invasive Cardiac Surgery, Division of Cardiothoracic Surgery, UK College of Medicine, performed a coronary artery bypass grafting (CABG) using the da Vinci® Surgical System, developed by Intuitive Surgical.

Performed Jan. 13, 2004, on a 69-year-old female patient, Ellis Comfort of Lexington, the procedure was the first in Kentucky to use a robotic system to improve the capabilities of surgeons in the operating room. During the procedure, surgeons used the system to help detach a mammary artery from under her sternum. Cardiothoracic surgeons performed this procedure to bypass blockages of her coronary arteries.

“Her post-operative course was uneventful and she has recovered well from her surgery,” Ramaiah said.

Comfort said she is not only celebrating her one-month anniversary of her successful surgery, but also another special occasion, her 50th wedding anniversary.

Traditionally, heart bypass surgeries require a large 8- to 10-inch incision through the chest wall. The robotic system at UK allows surgeons to insert instruments through tiny ports, placed within one-centimeter incisions in the body. Surgical procedures using the robotic system require a minimum of three incisions; one for a camera and two for surgical instruments. Surgeons can rotate the instruments 360 degrees through the incisions.

“This system allows me to use a full range of motion with the robotic surgical instruments with greater precision than traditional surgical procedures,” Ramaiah said.

The robotic surgical system allows the surgeons to perform enhanced surgical procedures by translating the natural hand, wrist and finger movements on the system controls to corresponding movements of the instrument tips.

Surgeons who use the robotic surgical equipment must first complete hands-on training with animal and cadaver models.

The new robotic surgical system at UK Hospital provides a cutting-edge approach to medicine that allows patients to spend less time recovering after a surgical procedure. When compared with procedures performed with traditional surgical instruments, patients often need less anesthesia and experience a faster recovery with less blood loss and scarring, less post-operative pain and discomfort, and a reduced risk of infection.

The robotic surgical system includes three components: a surgeon’s viewing and
control console, including a three-dimensional viewing system; a patient side cart with robotic arms to position endoscopic instruments; and a vision cart with all the audiovisual controls and an extra monitor for the rest of the surgical team.

“The robotic surgical system allows me to put my hands and eyes inside a patient’s body without touching the patient during a procedure,” Ramaiah said.

Heart disease is the leading cause of death in the United States and one of Kentucky’s most serious health concerns; a CABG is the most commonly performed heart operation.

“During a CABG procedure performed with traditional instruments, surgeons may crack the ribs or sternum during mammary procurement, often leading to back pain. By using the robot, we do not have to elevate the sternum and we can reduce the potential for back pain,” Ramaiah said.

“This robotic technology allows surgeons to perform a superior quality procedure because of the realistic field of vision and greater precision,” said Robert Mentzer Jr., M.D., the Frank C. Spencer Professor and Chairman, Department of Surgery, UK College of Medicine.

UK Hospital is the first medical facility in Kentucky to offer surgeries utilizing a robotic surgical system. UK Hospital purchased the $1,290,000 robotic system in December.

“The advancements of medical technology in today’s world are absolutely incredible,” said Joseph O. Claypool, FACHE, director of UK Hospital.

“The citizens of our communities expect the academic health center to be continuously on the leading edge. However, the reimbursement for these technologies
does not keep pace with the rapidity of the new advances. This forces us to pick and choose specific technologies that we feel are going to best benefit the population that we serve. That is exactly what we did in choosing the da Vinci. We believe this
technology is important for the future of many surgical procedures,” Claypool said.

The robotic surgical system soon will be used for urological, vascular, neurological, pediatric, and complete cardiothoracic surgical procedures.

For more information about the University of Kentucky Hospital, visit the Web site.


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