Henrico Doctors' Hospital First in Mid-Atlantic Region to Perform Closed-Chest "Open Heart" Surgery

(Richmond, VA) - A heart bypass surgery that has ordinarily required a 10-inch incision, a split in the breastbone, and a retractor to separate the sternum, was performed totally endoscopically by Dr. Marc R. Katz, M.D., of Cardiac and Thoracic Surgical Associates, Ltd. Using the computer-assisted da Vinci™ surgical system, Dr. Katz and his team on Friday, September 27, performed one of the first minimally invasive, closed-chest coronary artery bypass surgeries in the country. The operation was the first of its kind in Virginia or the mid-Atlantic region. "This is the beginning of a whole new era in cardiac surgery," said Dr. Katz. "I’ve been training for years including time in Europe to prepare for this procedure. This is a very exciting breakthrough for heart patients."

When asked about his bypass surgery, Richard Eastman, the 69-year-old patient from Colonial Heights answered in jest, "What surgery?" He added, "I’m way too young to retire, and I’ll be back at work in no time. It’s been just 3 days and I already feel much better now than I did before the surgery. People don’t even realize I’ve had heart surgery since there is no giant scar on my chest—just three tiny little scars." When asked if he was apprehensive prior to undergoing the new procedure, Eastman said. "Dr. Katz did a good job of explaining this so I did not feel frightened about it at all."

"Patients experience far less pain, greater freedom of movement, a shorter hospital stay, and a faster return to work with minimally invasive surgery," said Dr. Katz. Normally, after undergoing an open-heart bypass, patients are not allowed to lift or drive for one month and must avoid heavy lifting for three months. With this less-invasive approach, patients have substantially fewer restrictions on these activities. Being up and active much sooner lowers many risks.

The procedure involves grafting the mammary artery to the left anterior descending artery (LAD). "This has repeatedly been proven to be the single best and most enduring procedure performed for coronary artery disease," said Dr. Katz, "And now to be able to offer this via tiny ports makes it even more appealing."

Using only 3 small incisions, each less than 1 cm, doctors utilize the da Vinci™ system to perform the bypass. One opening allows access for the endoscope, a tiny camera that is attached to a fiber-optic cable. The other 2 openings or ports provide access for surgical tools and EndoWrists™. Instead of the surgeon holding the tools, the robot’s wrists hold them – bending back and forth, side-to-side and rotating in a full circle—thereby providing a range of motion and dexterity that is equivalent to the human hand but only requiring ports of less than ½ inch.

The movements of the "robot’s" wrists are controlled by the surgeon who sits at a computer console which provides high-definition, full-color, magnified 3-D images of the surgical site made available by the endoscope. One of the most important built-in components of the technology is that it enhances the surgeon’s hand movements and renders them more precise with fewer tremors.

Becoming proficient in operating the da Vinci™ takes years of training, hours in labs and a desire to be on the cutting edge of cardiac surgery. Many hospitals are buying the da Vinci™ but few surgeons have mastered the technique necessary to perform an entire coronary bypass surgery. The procedure has been performed at only four hospitals in the United States – Henrico Doctors’ Hospital, two hospitals in New York, and one in California.

Henrico Doctors’ Hospital was one of only 12 hospitals in the country chosen in January 2002, to participate in a clinical trial to conduct closed-chest coronary artery bypass surgery using the da Vinci. Patrick Farrell, Henrico Doctors’ Hospital CEO, said, "Being selected as a site for the trial is certainly a compliment to Dr. Katz and our hospital’s initiative to find minimally-invasive ways to help our patients." Such trials are often reserved for major teaching hospitals such as Columbia and Harvard. Farrell said it was Dr. Katz' experience with the da Vinci™ and his experience training other cardiac surgeons throughout the country that won the opportunity for the hospital.

The clinical trial is sponsored by Intuitive Surgical of Sunnyvale, California, manufacturers of the da Vinci™ surgical system and is further supported by the chosen hospitals.

A video clip of the procedure, in addition to pictures and other information about the da Vinci, can be found at the da Vinci™ website at www.intuitivesurgical.com. The next goal of the da Vinci™ manufacturer is for a U.S. surgeon to perform the procedure on a beating heart, avoiding the use of a bypass or heart-lung machine during the surgery. While these surgeries are being performed successfully abroad, they must receive approval by the FDA before being performed in the United States.

Henrico Doctors’ Hospital, with campuses at 1602 Skipwith Road (Forest Campus) and 7700 E. Parham Road (Parham Campus), was the only hospital in Virginia chosen as one of the Solucient 100 Top Cardiovascular Hospitals. The da Vinci™, purchased by the hospital in July of 2000, is regularly used for a variety of minimally invasive surgeries. Henrico Doctors’ Hospital maintains a reputation as a hospital that delivers innovative, world-class health care in a community setting.

For more information, patients and physicians may call Dr. Katz at 804-282-8777 or (800) 222-1024. Or, for additional news releases about the da Vinci™ surgical system at Henrico Doctors' Hospital, please visit our Press Room.