AGH robots simplify heart surgery
By Megan Guza
Published: Thursday, May 31, 2012, 8:08 p.m.
At 73 and with a badly failing heart, Joseph Scolero of Cranberry believed he had little choice but to become a medical pioneer.
"What do I have to lose?" Scolero asked himself before agreeing to let doctors at Allegheny General Hospital in the North Side use a robot to help perform a new minimally invasive coronary artery bypass surgery on him March 13.
"My heart was failing pretty bad," said Scolero, a former truck driver who struggled with long-term low heart function. "I told them to go for it. Go from there and see what happens."
The procedure, one of the first of its kind in Western Pennsylvania, allows surgeons to perform bypass surgery with less trauma and lower risk than traditional open-heart surgery.
Dr. Walter McGregor, AGH's director of robotic cardiac surgery, said the procedure has benefited those who are good candidates for it, such as Scolero, whose condition was not overly severe or complex.
"In the weeks leading up to the procedure, we noted that his heart function was low but had really dropped down significantly, to the point of occasional irregular heart rhythms," McGregor said.
With traditional heart surgery, doctors access the heart through a long chest incision and split the breastbone at the front of the rib cage. The robotic surgery, in contrast, is a closed-chest procedure performed by the robotic da Vinci Surgical System, which allows surgeons to work on the heart through a few small incisions.
Preparations to begin using the procedure were extensive, said McGregor, who has always had an interest in robotic surgery. The cardiology unit began to expand use of minimally invasive procedures without robots about two years ago. Training for using robotics took about six months.
"There was individual and team training," he said.
Surgeons observed live cases by doctors trained in the procedure, several of whom came to AGH to help train hands-on.
"There was extensive test-driving of the robot," he said.
The robot itself consists of three parts: the patient cart, the vision tower and the surgical console. The patient cart is the actual robotic component, a five-armed machine that performs the procedure. The surgeon controls the movements at the surgical console. The vision tower allows everyone in the room to see what the surgeon is seeing.
NASA first developed the technology to operate on astronauts in space, and the Department of Defense uses it on soldiers on the battlefield.
Scolero said he was surprised at how quickly he healed.
"Within a few weeks, the doctor said I was allowed to drive," he said. Patients who undergo traditional open-heart surgery generally cannot drive for six to eight weeks.
Scolero said his wife, Anita, had open-heart surgery 20 years ago, and after watching her recover, he was unsettled by the thought of undergoing such a dramatic procedure at his age.
He said he is feeling the benefits of the new procedure. "It did me a lot of good," he said. "I'm feeling good. I have more energy back.
"I was in a position where I had no choice. Something had to be done," he said.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.