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AGH robots simplify heart surgery

Philip G. Pavely | Tribune-Review
Dr. Walter McGregor discusses the robotic heart procedure at Allegheny General Hospital in the North Side that likely saved the life of patient Joseph Scolero. McGregor used a da Vinci Surgical System robot to perform a closed-chest, minimally invasive procedure for coronary bypass.

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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.

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