Robotic Surgery On a Beating Heart

An anonymous reader writes "Serious heart surgery usually involves stopping the organ and keeping the patient alive with a cardiopulmonary bypass machine. But this risks brain damage and requires a long recuperation. Scientists at Harvard University and Children's Hospital Boston have now developed a device that lets surgeons operate on a beating heart with a steady hand. The 'robotic' device uses 3-D ultrasound images to predict and compensate for the motion of the heart so that the surgeon can work on a faulty valve as it moves. The approach should improve recovery times and give a surgeon instant feedback on the success of the procedure, the researchers say. Here's a (slightly gory) video of the device in action."

Poe

[dasheiff]

Edgar Allan Poe would be proud.

Re:What if something goes wrong?

[TheLazySci-FiAuthor]

...Surgeons typically respond better than machines to unpredicted circumstances.

True, and a good point.

I wonder what the probability is of an event occurring which would require the flexible, though less precise, ability of the Surgeon versus the increased success afforded by the inflexible, but precise, machines.

in other words, statistically speaking, does the risk of unpredictable events outweigh the benefit of increased quality of operation.

Re:What if something goes wrong?

[Gat0r30y]

It would also seem to me that an arrhythmia would be much more likely to occur during such a procedure, since the heart (and generally the whole body) of the patient is under a significantly higher amount of stress during open heart surgery. But I guess the real answer would lie in the control system designed to predict the future behavior of the organ. Does it use a regular heartbeat to predict future behavior? Or, much more likely in my view, does the software use the ultrasound to predict future behavior independent of any particular "regular" heartbeat? I can say that if I were designing such a control system I would not want a set "regular" heartbeat as an expectation, I would much rather use the ultrasound to feed forward information from each chamber independently, so that even if there were an arrhythmia the compensation would not be directly effected.

Re:What if something goes wrong?

[Ethanol-fueled]

To add to your point, it's not just the increased precision, it's also about not having to rip other stuff open which increases the risk of complication.

Operations which required 6-inch incisions(think hernias and appendectomies) can be done with half-inch incisions thanks to technology. I'd gladly be touched by a robot as long as it left less of a mess on the way out. Plus, there's less of a risk of the doc leaving instruments inside when he sews you up. It happens, so don't laugh :)

Re:What if something goes wrong?

[The Gaytriot]

I'd say that's the point of the ultrasound. Otherwise, if the robot simply attempted to predict the position of the heart by it's rhythm alone there would be serious issues.

Using the ultrasound, which updates the position to a computer (probably updating around 4-5 MHz), means that the robot can compensate for the position close enough to real time that it can avoid mistakes (there is still the tiny delay).

Any irregularities due to Arrhythmia should not be an issue, the heart will probably not change beating faster than the computer and robot can compensate.

Sat in on one once...

[angrytuna]

I was able to sit in on an open heart surgery at one point in my life. After the surgeon cracked the chest open, he inserted a surgical glove full of (I think) normal saline, tied off at the wrist. Called it a 'helping hand'. The heart continued to beat merrily away on top of it, and they used a device called an octopus [medgadget.com] to hold the pertinent section of the heart still.

To date, remains one of the coolest things I have ever seen.

Re:What if something goes wrong?

[Trifthen]

I was wondering about that myself. My open-heart surgery in 1984 obviously used the old method of hypothermia to stop the heart, and as expected, required several hours to install a dacron patch to close a ventricular septal defect, close an atrial septal defect, widen my pulmonary artery, and surgically separate my tricuspid and mitral valves... and that was just what they could fix back then. That's a ton of crap, and I have to wonder how effectively a robot could work on a beating heart while having it open and basically re-arranging the entire inside.

Then again, this seems obviously aimed at things like bypass surgery. I still have to wonder how invasive this technology can get before it gets too risky.

Robot vs. Reboot

[thewiz]

I, for one, would be happy to have a robot operate on me if I ever have a fourth open-heart surgery. The three surgeries I've had required that I be attached to a cardiopulmonary bypass machine, have my heart stopped by electric shock, sternum cut and rib cage spread open, and be restarted by another electric shock when they were done.

Trust me, hot-swap is much better than a cold reboot!

Re:NOW they tell me!

[theaveng]

Pretty soon they'll just use robots (nanites) and won't need a surgeon at all, except to act as a kind of "general" giving orders to the tiny machines.