Telemedicine and Robotic Heart Surgery

Australian heart doctors recently performed heart surgery on a patient that was not even in the same room. Physicians in Adelaide used a robotic surgery device to treat patients with atrial fibrillation. Doctors advanced a robotic surgical arm holding a special catheter through the patients’ blood vessels until it reached the desired target deep within the chest. The device delivered a pulse of radio frequency energy as directed by heart doctors sitting in the next room 

over, watching the process on monitors.

Robotic surgery is not a terribly new concept. While it is still not completely standard equipment like a CT scanner, there is at least one example of a robotic surgical device in most large medical centers in the United States. These devices include two parts, one section has several robotic arms that are used as surrogates for the surgeon’s hands and contain various surgical instruments built within it. The other part is a console with a screen and a sophisticated version of a joystick at which a surgeon is seated and drives the robotic arms.

Atrial fibrillation is a condition in which abnormal electrical signals cause the small chambers of the heart (atria) to contract inappropriately and out of sync with the rest of the heart. Atrial fibrillation is usually caused by a cluster of nervous tissue near the border between the heart and the lungs. If you can snake a catheter to that site and ablate (destroy) the problematic tissue, you can cure atrial fibrillation. While interventional cardiologists have been doing this for years, they have only recently started doing it remotely.

The makers of the da Vinci Minimally Invasive Robotic Surgical System, one of the leading manufacturers of robotic surgery technology, have long discussed that there equipment is designed and intended to be used all within the same surgical room. The physician sits at a console that is physically next to the patient’s operating table. Obviously, though, the implications for telemedicine are profound. If the surgeon need not be physically present during a surgery, surgical techniques could be brought to remote locations without large surgical hospitals.

A cardiothoracic surgeon could sit at a console in his New York office and drive the robotic arms of a device in a clinic in Kenya. While intercontinental surgery is still a dream, by stepping into the next room Australian physicians have made a giant leap for the advancement of telemedicine.