ABSTRACT 88

USE OF A SURGICAL ROBOT AS A SURGEON CONTROLLED FIRST ASSISTANT IN CARDIAC SURGERY: AN EXPERIMENTAL CADAVER STUDY

Steven Gundry, MD, *Scott Hammond, Geoff Visbal, Loma Linda University Medical Center, Loma Linda, CA and *Computer Motion, Goleta, CA.

Although robots are now under investigation to extend the surgeon in minimally invasive heart surgery, we felt that rather than replacing the surgeon, a more useful role of the robot is as a surgical first assistant controlled by the surgeon. We tested this concept in the cadaver lab using fresh cadavers to take down both the right and left internal mammary arteries during a ministernotomy and to provide a first assistant holder of a vascular graft, vein graft, internal mammary artery, and sucker blower.

The Zeus  Surgical Robot (Computer Motion, Goleta, CA) was positioned using one or two robotic arms as needed opposite the surgeon who stood at the table in the normal position.  The controllers for these arms were positioned so that they stood at either side of the surgeon. Thus, the surgeon could manipulate the robotic arms from the standard position at the surgical table rather than seated away from the patient. Visualization was provided either directly or with the assistance of Aesop Surgical Telescope using voice control. In this manner, the surgeon controlled what would normally be expected of a first assistant, that is grasping, retracting, sucking, positioning, by placing the robotic arms in position and then locking them in place. A specially designed footplate allowed independent activation of either arm.

The utilization of the robot as a surgical assistant allows a machine to take over many of the tiresome aspects of first assisting in surgery. The robot does not fatigue, the robot never looses interest, and the robot does not need to be fed or praised. Moreover, since the surgeon controls the robot, the surgeon becomes his own first assistant, positioning these arms exactly where he desires. A clinical trial for the robot as a first assistant is currently in submission.