[HSF] Mitral Valve

[erdinç naseri]

prasanna,
what is the length of a blade size incision
erdinc> Date: Fri, 4 May 2007 17:35:13 +0530> From: prasannasimha at gmail.com> To: OpenHeart-L at lists.hsforum.com> Subject: Re: [HSF] Mitral Valve> CC: > > That is why I tell my residents when I do a PDA with a blade size incision -> don't even think about it till you at least cross 100.> Prasanna> > On 5/4/07, Hgrmd at aol.com <Hgrmd at aol.com> wrote:> >> > Ani,> > You bring up some excellent points regarding the marketing of minimally> > invasive mitral surgery. There are lots of surgeons out there who think> > that> > they can develop a significant mitral repair practice by learning to do> > it> > noninvasively. That is a dangerous mind set. Before one learns a> > minimally> > invasive technique, it is essential that they have mastered open mitral> > repair.> > >From what I've been told by the Intuitive reps as well as master> > surgeons> > who do robotic repairs, there are some surgeons who use the robot for a> > small> > part of the operation. That way, the patient believes he got a "robotic"> > repair.> > That is not my approach. I do robotic mitrals through a 20 mm port,> > regardless of the patient's size. Granted, I currently don't do morbidly> > obese> > patients with this approach, though there are experienced surgeons who> > do. In> > addition, if the preop TEE tells me the repair is going to be highly> > complex> > (like the one you just privately related to me), then I advise the> > patient to> > get it done open. It's much more important for a patient to have a> > repair> > than to have a small incision. My robotic mitrals are done start to> > finish> > with the robot. So far, no reops or bad echos. However, I can tell you,> > the> > stress is substantial, and I can't imagine the torture an inexperienced> > mitral> > repair surgeon would feel trying to use this platform for a complex> > repair.> > For one thing, I think these robotic cases should mainly be limited to> > myxomatous disease. Patients with pure annular dilatation need a full,> > semirigid> > ring. Those rings can't be installed with Coalescent U-Clips. Try> > suturing> > in a semirigid ring with a robot. Suture mangement is a total nightmare.> > Thus, if this approach is for MVP, we all know that a lot of experience> > is> > required to reliably repair them. I don't think it's possible to safely> > learn> > that with the robotic approach. You have to crawl before you can walk.> > Hal> >> >> >> > ************************************** See what's free at> > http://www.aol.com.> > _______________________________________________> > OpenHeart-L mailing list> >> > Send postings to:> > OpenHeart-L at lists.hsforum.com> >> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> > http://mmp.cjp.com/mailman/listinfo/openheart-l> >> > All messages transmitted by the OpenHeart-L are subject to the policies> > and> > disclaimers posted at:> > http://www.hsforum.com/listdisclaim> > -----------------------------------------> >> > > > -- > Prasanna Simha M> _______________________________________________> OpenHeart-L mailing list> > Send postings to:> OpenHeart-L at lists.hsforum.com> > To UNSUBSCRIBE, to CHANGE email address, or to view archives:> http://mmp.cjp.com/mailman/listinfo/openheart-l> > All messages transmitted by the OpenHeart-L are subject to the policies and > disclaimers posted at:> http://www.hsforum.com/listdisclaim> -----------------------------------------