[HSF] Robotic CABG

[Ajit Damle]

We have the robot since 2000. Had a big fanfare and web cast in 2000. Our
administrators also arranged a contest in local primary school children to "
Name the Robot"!

The 3D vision is fantastic, but the lack of tactile feedback and the
awkwardness of use more than offset it. After trying in several IMA harvests
initially, I gave up. But we do have one surgeon who persisted and does IMA
harvest robotically and then the anastomoses on beating heart through a
small left thoracotomy. Perhaps 12-15 cases a year, out of some 350 total
CABGs/ yr. Our hope was to do LIMA-LAD robotically and then the
cardiologists can stent the rest. This has not been very popular with the
cardiologists, though.

We have no other use for it. Urologists will not use it. As I understand,
the costs are staggering, I am not sure of the numbers. Close to a million
dollars to buy, 100,000 dollars a year maintaining contract ( I may be wrong
here), each procedure costs at least 2-3000 dollars per case (the robot
reads the instrument codes and does not allow use after some 10 uses,
ostensibly to make certain that the instruments are in good shape). There is
no separate re-imbursement for this.

I guess there always will be software updates. Also, without any
competition, there is little incentive for the company to improve the
product.

Our administrators think, that in spite this, this might be money well
spent, as it gave us a lot of publicity locally. Even today, most young
patients, and also sometimes some elderly lady from small town North Dakota
will come to us and demand that CABG be done robotically! 

Ajit Damle
Fargo ND

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of john pj
Sent: Friday, March 02, 2007 7:43 AM
To: OpenHeart-L at lists.hsforum.com
Subject: [HSF] Robotic CABG

 
   
  It seems most of the centres which have pioneered robotic CABG no longer
pursue it.
   
  It seems it   has very  little applicability in day to day  work .

 
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