''Touch-Free'' Heart Surgeries Performed on Children and Adults with Complex Congenital Heart Disease at California Pacific Medical Center.

Health/Medical Writers

SAN FRANCISCO--(BUSINESS WIRE)--Oct. 20, 2003

Mini-Incisions Mean Less Pain & Scarring, Less Infection and

Faster Recovery for Patients

"Touch-Free" heart operations -- using tiny incisions in the chest in combination with miniaturized instruments, digital cameras and robots -- are now routine at California Pacific Medical Center. Patients -- whether a neonate or an adult -- do not need to undergo heart surgery by techniques of the past.

Dr. Michael Black, chief of California Pacific's Division of Pediatric Cardiac Surgery and the surgical director of its Pediatric and Adult Congenital Heart Program, is an internationally-known pioneer in the robotic, minimally-invasive repair of heart defects. Dr. Black has developed equipment that makes such surgery possible and has traveled abroad to teach/perform his "touch-free" techniques in Asia. "Seeing children with 'band-aid' sized incisions and no breathing tubes as they roll out of the operating room is very gratifying," he says. Most children are discharged home within 2 days after the repair.

Robotics and video assisted cardiac procedures allow surgeons to get closer to the surgical site than human vision will allow, and to work at a much smaller scale than conventional surgery permits. California Pacific Medical Center recently acquired the da Vinci(TM) Telemanipulator to complement Dr. Black's surgical philosophy.

Traditional heart surgery requires that the patient's chest be "cracked" open by way of a large midline incision, accompanied by the division of the entire sternum or breast bone. Traditional large thoracotomies or incisions between the ribs may be painful and disfigure girls as they pass through adolescence. With video assisted surgery and robotics, Dr. Black is able to perform delicate procedures on the heart utilizing 3 to 4 small ports.

"Robotics is revolutionizing the practice of cardiothoracic surgery," according to Dr. Black. "Being able to operate in the deep recesses of the chest can be difficult with long instruments and a camera. Imagine trying to tie your shoe laces with a long plier and a flashlight. Robotics allows the surgeon to approach the problem with the same dexterity that one is accustomed to," he says.

Patients benefit from robotic surgery by:

-- Less blood loss which decreases the potential need for

transfusions;

-- Less post-operative pain or discomfort;

-- Decreased risk of infection since the surgeon's gloved finger

never makes contact with tissue;

-- Significantly shortened hospital stay;

-- Faster recovery;

-- Less scarring and much improved cosmesis.

Sitting approximately eight feet away from the patient, Dr. Black moves highly-sensitive instruments on a computer console that direct the camera-equipped, three-armed robot. The patient's heart is magnified on a screen. The robot precisely matches Dr. Black's hand and wrist movements, translating them to tiny instruments placed inside the patient through the minimal incisions.

"The robot can be so delicate and precise, you can place sutures the size of a human hair in a very tiny area," Dr. Black says.

This "touch-free" technique allows Dr. Black to operate on the smallest patients (the youngest to date being 28 weeks gestation or equivalent to a second trimester fetus), with heart-lung machines modified for the patient's decreased size. In Dr. Black's fetal lab, he has mastered his ability to maneuver in very small spaces and cannulate devices and tubes in very tiny vessels. "We are encouraged that our initial experience performing such complex robotic heart surgery in the fetal lab can translate to premature neonates. We can offer parents hope that even the most premature infants can routinely undergo corrective open heart surgery in the near future.

About Michael D. Black, M.D., F.A.C.S.

Michael D. Black, M.D., F.A.C.S., received his medical degree from the University of Toronto, Ontario, Canada. He completed a fellowship in cardiovascular surgery at the Hospital for Sick Children in Toronto, where he was an R.S. McLaughlin Scholar. He has served as a clinical instructor at the Division of Pediatric Cardiothoracic Surgery at the University of California, San Francisco. Before joining California Pacific Medical Center, Dr. Black was chief of cardiac surgery at Lucile Packard Children's Hospital at Stanford University and an associate professor of Surgery at the University of California, San Francisco.

About California Pacific Medical Center

California Pacific Medical Center, a Sutter Health affiliate, is one of the largest private, not-for-profit teaching medical centers in Northern California. We are a tertiary referral center providing access to leading-edge medicine while delivering superior personalized care. CPMC provides a wide variety of services, including, acute, post-acute and outpatient hospital care; home care and hospice services; preventive and complementary care; and health education. Through our medical education program and our research institute, physicians at California Pacific Medical Center are able to bring health care innovation to the bedside.