Robotic Heart Procedure at Saint Michael's Medical Center is Area's First

NEWARK, N. J. (October 30, 2009) –– Doctors at Saint Michael’s Medical Center have performed an advanced laser heart surgery using robotic technology — the first time the operation has been performed robotically in the tri-state area.

The robotic technology enabled surgeons to create new pathways in the heart muscle of a 52-year-old diabetic man without creating a large surgical incision or opening the patient’s rib cage.

Instead, surgeons at Saint Michael’s used robotic technology to access the patient’s heart through three tiny incisions — each about the size of a pencil eraser — to perform TMR, or transmyocardial revascularization.

“The patient was sitting up in his chair six hours after the operation. It was remarkable,” said Dr. Mark Connolly, a cardiothoracic surgeon and director of The Heart & Vascular Institute at Saint Michael’s Medical Center. “This was a complex patient with end-stage heart disease and this was his only real option,” Dr. Connolly said.

The patient went home two days after surgery and is doing very well, his doctors said.

Dr. Nilesh Patel, the hospital’s chief of Minimally Invasive Robotic Cardiac Surgery and among the nation’s most experienced robotic heart surgeons, performed the surgery under the supervision of Dr. Connolly.

Dr. Patel said the TMR surgery underscores the emergence of robotics as a powerful tool for the heart surgeon.

“This is a new concept and I personally think it is the future of heart surgery,” Dr. Patel said.

Dr. Patel is among only ten surgeons in the United States to perform TMR with the robot technology, said Richard Lanigan, executive vice president of marketing at Cardiogenesis, the California-based company that manufacturers the TMS Laser System.

“This minimally invasive approach to delivering TMR means patients face lower risk and a shorter recovery.”

TMR can help patients who continue to have severe chest pain despite previous coronary artery bypass surgery, angioplasty and medications. These patients often cannot climb stairs or perform simple chores, such as carrying groceries. With TMR, surgeons use a state-of-the-art laser to create channels into the heart muscle. The channels generate increased blood flow into new blood vessels, reducing chest pain and improving the patient’s quality of life.

Dr. Patel also has used the da Vinci Robotic Surgery System to perform more than 600 coronary artery bypass graft procedures, known as minimally-invasive direct coronary artery bypass surgery.

“The traditional way of doing heart bypass surgery is to cut open the breast bone, which in and of itself carries a chance of bleeding, delayed healing time and infection,” Dr. Patel said. “With this system, I can do the whole operation using tiny incisions. The patient comes out of the operating room fully awake. The next day they are in their own room — and back to work in two and a half weeks.”

A study published in 2008 in the Annals of Surgery found the use of robotics for heart bypass surgery reduced major adverse events, blood loss and wound infection. Patients left the hospital sooner and returned to their normal lives more quickly, the study found.

Robotic cardiac bypass surgery currently is limited to certain bypass grafts. Some surgeons predict more surgeries will be possible as the technology advances.

Saint Michael’s has been at the forefront of cardiac innovation since it opened New Jersey’s first specialty center for the study and treatment of cardiac disease in 1937. Saint Michael’s established the state’s first cardiac catheterization lab in 1949. Doctors at the hospital performed the state’s first open heart surgery; the state’s first coronary bypass procedure and the state’s first coronary angioplasty.

Established by the Franciscan Sisters of the Poor in 1867, Saint Michael’s Medical Center is a 357-bed regional tertiary-care, teaching and research center in the heart of Newark’s business and educational district. Saint Michael’s Medical Center is a member of Catholic Health East (CHE). Based in Newtown Square, Pennsylvania, Catholic Health East is one of the nation’s largest nonprofit health systems, with 34 hospitals in 11 states. More information is available at www.smmcnj.org.