Doctors use robots to aid heart surgery

A FRENCH medical team has conducted the first remote-control, open-heart surgery, using robots and computers developed by an American company.

The six operations, successfully performed this month at the Broussais hospital in Paris, may constitute a breakthrough in cardiac surgery as significant as the first heart transplant in 1967 and the first open-heart operations in 1956.

In the long run, the techniques should permit the development of new forms of heart surgery too minute and complicated to be performed by the human hand. Within five or 10 years, further developments in telecommunications may allow the most skilled surgeons to perform emergency surgery on patients hundreds, or even thousands of miles away.

The experimental operations were conducted by an internationally-renowned French team led by Professor Alain Carpentier. Although the technology was developed by an American company, Intuitive Surgical from Stanford in northern California, US federal regulations do not yet permit remote- control cardiac surgery on human beings.

Professor Carpentier said the six pioneer operations - relatively straightforward forms of heart surgery such as coronary by-passes and repairs to congenital faults - had been a "total success". A tiny camera and probes with micro- instruments were introduced into the heart through up to three incisions in the chest, between one and four centimetres wide.

The professor, sitting in front of a video screen three metres away, manipulated the micro-instruments attached to robot arms, which are capable of responding instantly and with extreme precision to the surgeon's commands.

"The surgeon really feels he is sitting in the middle of the patient's heart," Professor Carpentier said. "He has greater precision and a better view." The next step, he said, would be to attempt operations which would be "very difficult or impossible" using the human hand and traditional instruments.

Operations conducted by a surgeon many miles away would not be possible with existing telecommunications technology. Even at a distance of 100 miles, there would be a, potentially disastrous, delay of up to one second before the robot arms responded to the surgeon's commands. The company which developed the technology believes, however, that within five years developments in communications technology will allow commands to be transmitted instantly over long distances.

This would allow eminent surgeons to conduct operations on patients thousands of miles away. The company believes that robotic heart surgery may become the norm, even for routine operations. The new technique avoids a large incision in the chest, and allows more precise surgery. Patients are less exposed to infection and should recover more rapidly.