Open heart surgery is not for the faint of heart. Even among surgeons, it is a field reserved for only some of the most skilled doctors. The only choices available at present are either to stop the heart completely during surgery or to operate on it while it is beating.
If the heart is stopped during surgery, as is the case in the majority of cases, a mechanical pump takes over the job of keeping the blood circulating until the heart is restarted. This can be an extremely traumatic experience for any patient and especially for those who already have serious cardiovascular problems.
The other option used by some pioneering surgeons to avoid the trauma involved in the above method is to cool the heart down during surgery. Although this slows the heart down considerably, it does not stop the heart completely and, thus, the surgery must be performed on a moving object.
Now, new technology may make it possible for surgeons to work on the human heart while it is beating. Robotic tools combined with an innovative software program will allow the surgeon to see a beating heart that appears to be stationary.
The surgical instruments can then be used in a way that matches the movement of the heart.
According to surgeon Rajesh Aggarwal, a software developer from Imperial College London, “It’s a difficult procedure on a stationary piece of tissue, let alone when it is moving.”
The new software, developed by George Mylonas at Imperial, serves to synchronize the heart’s beat with the robotic movement to present a 3D model of the heart that, in turn, makes it appear as if the surgery is being performed on a stationary heart.
The software is used with the da Vinci robot, which has a two-camera endoscope that provides the surgeon with images of the heart. The software creates a 3D model of the heart which appears stationary. It also controls the robotic instruments so as to make them move in any direction. This additional feature could allow surgery to be done without opening the chest cavity.
The software, which was presented at the Medical Device Technology conference in Birmingham, is currently limited to testing on an artificial heart with a robotic arm.
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