Canada

Smooth recovery

A new heart-bypass procedure eliminates the need to open the chest

Robert Marshall October 18 1999
Canada

Smooth recovery

A new heart-bypass procedure eliminates the need to open the chest

Robert Marshall October 18 1999

Smooth recovery

Canada

A new heart-bypass procedure eliminates the need to open the chest

Last year, a medical team at the Health Sciences Centre in London, Ont., set a Canadian first when it used a robotic device to cut a piece of a blood vessel from a patient’s chest wall for use in an otherwise standard coronary bypass procedure. Surgeons elsewhere have pioneered bypass operations while the heart is still pumping. Some are using so-called keyhole alternatives for a variety of formerly invasive surgeries. Now, the London team has put it all together, completing the first-ever bypass surgery done a) with robotic assistance, b) on a beating heart and c) without opening up the chest cavity. The patient, John Penner, a 60-year-old dairy farmer from nearby Seaforth, Ont., was home four days after the Sept. 24 operation, several days short of the standard hospital stay for by-

pass patients. Penner says he felt wonderful within 24 hours of the procedure and is busy again tending his 20 young catde. “It’s a great feeling,” he says, “to be back at work without having to stop for a rest every five or 10 minutes.”

Using a $ 1.25-million robotics system bought with a gift from local philanthropists, cardiac surgeon Douglas Boyd performed the six-hour procedure from a console six feet away from the operating table. His equipment controlled three miniamre robotic arms, one hold-

ing a video camera. Entering Penners chest through tiny incisions, they cut a piece of a blood vessel from his chest wall then—for the first time—sewed it onto a coronary artery to let the blood flow around a blockage.

The procedure spares patients the long, painful recovery from having their ribs pried apart to give the surgeon access to the heart. And it avoids the risks of a stroke or other complications associated with stopping the heart and running the blood though a heartlung machine. Acknowledging that the new technology presents its own potential risks, Boyd plans to introduce the technique gradually. He expects to use it initially in about 85 of the 1,700 bypass procedures the hospital does each year. But ultimately, he thinks it will work for almost a third of bypass cases and for heart valve repairs. John Penners experience, says Boyd, provides “a preview of cardiac surgery in the new millennium.”

Robert Marshall