Newswise — Dr. W. Randolph Chitwood Jr. successfully performed his 400th robot-assisted mitral valve repair Friday, June 20, 2008. The surgeon has performed more of these surgeries than anyone else.
The operation took place at Pitt County Memorial Hospital, the teaching hospital of the Brody School of Medicine at East Carolina University, where Chitwood is a faculty member.
The patient was a 38-year-old man.
Eleven cardiac surgeons from across the county observed the historic procedure while attending a two-day training program. Chitwood's robotics training center at ECU is the first site in the United States to offer formal training in robotic-assisted mitral valve repair procedures.
"By integrating computer-enhanced technology with the surgeons' technical skills, robotic- assisted procedures enable surgeons to perform better surgery in a manner never before experienced," said Chitwood, president of the Society of Thoracic Surgeons, director of the East Carolina Heart Institute and professor of cardiovascular surgery at the Brody School of Medicine.
Chitwood is a pioneer in the development and expansion of mitral valve repair surgery, producing outcomes better than valve replacement, a once-prevalent surgical treatment for a leaky or narrowing mitral valve. An estimated 40,000 patients a year, many under the age of 50, have operations on their mitral valve, the inflow valve for the left side of the heart. More than 90 percent of these cases require a sternotomy, or cracking of the sternum, resulting in a 12-week recovery. With a robotic device there are only three small incisions, scaring is minimal, infection rate is lower and recovery time is lessened to two weeks.
"Not only is this technique far less invasive than traditional open-heart procedures, making it safer and far less painful for the patient, but repair of the valve, as opposed to replacement, has many additional benefits," Chitwood said.
According to research cited in Sept. 28 article in U.S. News & World Report, ""¦more than 90 percent of valve leaks can be successfully repaired. Compared with replacement, repair brings better heart function and less risk of infection, blood clots, and stroke. Patients live longer, too."
This 400th operation signifies the future for robotic-assisted cardiac surgery as surgeons are lerarning to perform this complex mitral valve repair procedure through Chitwood's training program. Typically, surgeons would replace a mitral valve with a mechanical device. These mechanical valves require lifelong dependence on blood-thinning medications, and some require additional replacement surgery approximately every 10 to 12 years.
In 1994, Chitwood began his pursuit to improve minimally invasive cardiac surgery and, specifically, the mitral valve repair procedure and did the first minimally invasive mitral valve repair in North America in 1996. Recognizing that endoscopic methods already used in surgery on other parts of the body could provide better visibility and access to the mitral valve, Chitwood devised a set of special instruments to simplify the repair procedure. The first totally endoscopic and robotic mitral valve repair in North America, and the second in the world, was completed by Chitwood in May 2000.
In 1999, Chitwood applied his endoscopic expertise to robotic technology and helped develop the da Vinci Surgical System, a $1.5 million robotic surgical device made by Intuitive Surgical of Sunnyvale, Calif. In 2000, Chitwood used the da Vinci system to perform the first complete robotic-assisted mitral valve repair in North America as part of a multi-center, FDA-approved trial. In November 2002, the FDA approved the robotic-assisted mitral valve repair procedure. Since then, many mitral valve repairs with the da Vinci have taken place around the world.
With the da Vinci Surgical System, surgeons make dime-sized incisions for inserting four robotic hands into the patient. One hand holds the camera that allows the surgeon to view in 3-D and magnify the surgical field 15 times, while the other three hands hold surgical instruments manipulated by the surgeon. Seated at a computer console apart from the operating table, the surgeon views the images on the console while controlling the surgical instruments that mimic movements of a human wrist.
The techniques of mitral valve repair are inserting a cloth-covered ring around the valve to bring the leaflets into contact with each other, helping them close properly as the heart beats, removal of redundant/loose segments of the leaflets, and re-suspension of the leaflets. Chitwood has used the Cosgrove-Edwards Band on all 400 robotic surgery mitral valve patients.
"We're proud to celebrate this milestone with Dr. Chitwood and his team, who are pioneers in the performance of robotic mitral valve repair and graciously share their knowledge with others in the surgical community," said Donald E. Bobo Jr., Edwards' corporate vice president, heart valve therapy. "The Cosgrove-Edwards Band's adaptable design allows it to be implanted with both minimally-invasive and robotic surgery techniques that many surgeons are training on and using in their practices today."
About East Carolina University's Brody School of MedicineSince 1977, when the first class of 28 students enrolled in the four-year School of Medicine, ECU's medical school has grown dramatically in its teaching, research and patient-care roles. Today, in its partnership with University Health Systems of Eastern Carolina and regional physicians, the school is the educational centerpiece of one of North Carolina's largest and most productive academic medical centers. In 1999, it was renamed the Brody School of Medicine at ECU in recognition of the continuous support of the Brody family.
In 2008, ECU and Pitt County Memorial Hospital will open the doors to the East Carolina Heart Institute, a new $220 million facility designed to strengthen the fight against cardiovascular disease, which accounts for 40 percent of all deaths in North Carolina. For more information, go to http://www.ecu.edu/med.
About University Health SystemsUHS is a regional health system serving 29 counties in eastern North Carolina. The system comprises Pitt County Memorial Hospital and six community hospitals throughout eastern North Carolina: Heritage Hospital, Roanoke-Chowan Hospital, Bertie Memorial Hospital, Chowan Hospital, The Outer Banks Hospital and Duplin General Hospital. PCMH, a tertiary referral center, is one of only four academic medical centers in North Carolina, and serves as the teaching hospital for the Brody School of Medicine at ECU. For more information, go to http://www.uhseast.com.
About Intuitive Surgical Inc. Intuitive Surgical is the global technology leader in robotic-assisted minimally invasive surgery. The company's da Vinci Surgical System offers surgeons superior 3D HD visualization, enhanced dexterity, greater precisions and ergonomic comfort for the optimal performance of minimally invasive surgery. More than 860 da Vinci Systems are installed in hospitals worldwide. For more information, please visit http://www.intuitivesurgical.com.
About Edwards LifesciencesEdwards Lifesciences is the global leader in the science of heart valves and hemodynamic monitoring. Headquartered in Irvine, Calif., Edwards treats advanced cardiovascular disease with its market-leading heart valve therapies, and critical care and vascular technologies. In 2008, Edwards celebrates 50 years of partnering with clinicians to develop life-saving innovations. The company's global brands, which are sold in approximately 100 countries, include CardioVations, Carpentier-Edwards, Cosgrove-Edwards, FloTrac, Fogarty, PERIMOUNT Magna and Swan-Ganz. Additional company information can be found at http://www.edwards.com.
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