About the Procedure
Robotic Assisted Mitral Valve Repair
Although robotic surgery has been viewed warily by some surgeons in the past, research data show that it is now a viable option for many patients. To date, more than 175 such procedures have been performed at Pitt County Memorial Hospital by Dr. W. Randolph Chitwood, chief of cardiothoracic and vascular surgery and vice chancellor for health sciences at the Brody School of Medicine at East Carolina University.
"During these first 176 operations, we have learned that cardiac surgery can be done safely using robotic techniques with the same results as a full sternotomy (full chest incision). Visualization and dexterity are much better," Chitwood said.
Chitwood pointed out that the majority of patients have excellent post-surgery recuperation results after minimally invasive, robotically assisted mitral valve surgery. The average length of stay in the hospital is less than four days compared with eight days for conventional open-heart procedures. Most patients are back to work in 10 to 14 days.
With the da Vinci Surgical System, Chitwood and his colleagues make three dime-sized incisions in the chest, through which they insert three robotic arms. One arm holds a tiny camera that projects three-dimensional images onto a monitor in front of the surgeon; the other two arms hold the pencil-sized instruments, which have tiny computerized mechanical "wrist" instrument tips designed to transmit the dexterity of the surgeon's forearm, wrist and fingers into the chest at the operative site.
Seated at a computer console located about 10 feet away from the operating table, the surgeon views a magnified, three-dimensional image and manipulates the surgical instruments using two fingertip controls.
The da Vinci Surgical System, developed and produced by Intuitive Surgical, was approved by the Food and Drug Administration for its first cardiac use (mitral valve repair) in November 2002. Chitwood served as principal investigator for the 10-hospital FDA Phase 1 study and the expanded Phase 2 study that led to that approval. The FDA clinical trials studied the safety and efficacy of the minimally invasive, robotic-assisted technique versus traditional sternotomy, or open-chest procedure, in repairing defective mitral valves.