FIRST COMPUTER-ASSISTED OPEN-HEART OPERAT ION

The recent development of less invasive intracardiac surgery using sma ll incisions and videoscopic techniques allowed an evaluation of the a dvantages and limitations of this new approach. Among the limitations was the increased difficulty of the surgical technique when using long instruments through small incisions and ports. We investigated whethe r computer assisted surgical instruments might bring a solution to thi s problem. Among the existing systems, we selected the Intuitive Syste m because of two original features. It provides a stable, magnified, t hree dimensional view of the operating field at a console where the su rgeon is seated to operate, and it uses computer assisted instruments having the same dexterity and range of motion as the hand. After 10 mo nths of active work to adapt this system to intracardiac surgery, the first open heart operation using computer assisted instruments was car ried out on a 52-year-old woman presenting an aneurysm and a large def ect of the atrial septum. The patient was extubated 8 h after the oper ation, returned to her room 16 h later and was discharged from the hos pital 8 d postoperatively with normal heart function and no residual s hunt. This preliminary experience showed that computer assisted cardia c surgery is feasible and may open new and promising directions in ope n heart surgery. ((C) Academie des sciences/Elsevier, Paris.)