Will Robots Someday Replace Surgeons?

Date: Aug-28-2012The U.S. Food and Drug Administration (FDA) has recently cleared the Corpath 200 system, the world's fist robotic-assisted system for minimally invasive treatment of coronary artery disease.

Philips Healthcare announced on August 22, 2012, that they will be the exclusive distributor of Corindus' interventional cardiology system in the United States.

The leading cause of death in the United States is coronary artery disease (CAD). In 2008, over 400,000 people died from CAD in the U.S., according to the Centers for Disease Control and Prevention.

CAD is the most common type of heart disease and is also often referred to as coronary heart disease (CHD).  It is characterized by the buildup of plaque and narrowing of the small blood vessels that supply blood and oxygen to the heart. Eventually, the disease causes the heart muscle to become weak, which leads to arrhythmias and heart failure.

This disabling condition can be treated by minimally invasive techniques, called Percutaneous Coronary Intervention (PCI). It is comprised of procedures such as:
coronary stenting- when a tube is placed in the coronary arteries that supply the heart in order to keep the arteries open
balloon angioplasty- when a tube with a tiny balloon at the end is used to widen the artery and restore blood flow which will reduce chest pain and minimize damage to heart muscle.

PCI is often performed in the catheterization lab by using X-ray imaging, and is one of the fasting growing markets in the U.S., estimating to reach $4.2 billion by 2018. Not only has PCI transformed the treatment paradigm for CAD, it has also reduced treatment costs, post-surgery complications, and patient recovery times.

Even though several benefits come from using PCI over traditional invasive treatments, there are still many challenges with current PCI procedures, including:
precise stent deployment
exposure to radiation
accurate visualization
accurate measurement of lesion length
stability of the guidewire and catheter

The CorPath 200 system is designed for robotic assisted placement of coronary guidewires and stent/balloon catheters used in PCI procedures. It is made up of a robotic drive and single-use cassette mounted on an articulating arm that attaches to the patient table.

In order to accurately visualize catheter progression while surgery is taking place, the CorPath 200 system is integrated with an X-ray fluoroscopy system. An interventional cardiologist operates the system from a shielded "interventional cockpit". The physician is able to perform the surgery by using simple touch-screen and joystick controls while he is seated in front of monitors that provide a view of the angiographic screen.

Robotic-assisted technology is the next generation of image-guided minimally invasive techniques in healthcare, according to GlobalData. The system addresses the challenges that are seen in PCI, while being compact and cost-efficient.

The interventional cardiologist is safe from radiation with the robotic system and is able to perform long surgeries feeling less tired and having reduced back pain by working in the "cockpit".

This system is compatible with commercial stents and devices, and even has the potential to improve treatment efficacy and enhance patient care, while allowing for:
enhanced visualization
discrete control and navigation of the guide wire and catheter
precise measurement of lesion length
After performing the CorPath PRECISE clinical trial, scientists found that there was a 100% clinical success rate, 97.1% decrease in radiation exposure to the clinician, and no occurrence of major adverse cardiac events.

Corindus and Philips will undoubtedly change the treatment of coronary artery disease with this system. Corindus, the global technology leader in robotic-assisted PCI, is leading the way in the vascular market. Philips, a global leader in interventional cardiology, helps clinicians provide better treatment by being at the forefront of imaging systems and interventional tools.

Together, these two will play an essential role in transforming the cardiac revascularization market by acknowledging the unmet needs of PCI by the development of novel solutions

Urology and invasive cardiac procedures, like coronary atery bypass grafting and mitral valve repair, already use existing robotic systems, like the da Vinci Si surgical system (developed by Surgical Intuitive). Urology often uses surgical robots for treatment of bladder cancer, prostate cancer, and kidney disorders. Worldwide, over 400 da Vinci robots are used for performing robot-assisted prostatectomy. PCI can be used to avoid a lengthy recovery time and intense medication regimen that is often associated with cardiac invasive procedures.

The CorPath 200 system is presented by the large PCI market, given the chance to create a niche for itself. There could be even more opportunities if the CorthPath 200 expands into other applications.

By adopting this robotic-assisted system, patients can expect to see a reduction in treatment costs and improved clinical outcomes.

This technology can lead the future to worldwide growth of robotic procedures in cardiology, that are already seen in urology.

Written by Sarah Glynn

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