Minimally Invasive Robotic Surgery for GERD

A multicenter trial is underway to evaluate the safety and effectiveness of minimally invasive robotic surgery for treating gastroesophageal reflux disease (GERD). The procedure, called Nissen fundoplication, involves wrapping part of the stomach around the esophagus to create a new valve that will prevent acid from refluxing into the stomach. Half of the patients in the trial will undergo conventional minimally invasive surgery without robotic assistance. One of the participating centers is the University of Pittsburgh (PA, USA), which has issued this report.

Doctors using robotic surgery in the study are using the Zeus robotic surgical system of Computer Motion (Goleta, CA, USA), which is sponsoring the study. The benefits claimed for surgery by this system are smaller incisions, reduced trauma, shorter hospital stays and convalescent periods, improved surgeon precision and dexterity, improved visualization, and minimized surgeon fatigue.

Surgeons create five small incisions, or ports, in the upper abdomen. One is used to insert an endoscope that enables the surgeon to view the operating area. Other surgical instruments are held and moved by the Zeus system through the remaining ports. While seated at the console, the surgeon views the operative site on a high-resolution monitor and operates handles that resemble conventional surgical instruments. The surgeon's hand movements are translated by the robotic arms into precise movements, while hand tremor is filtered by the computer. The surgeon controls the endoscope through voice commands.

"These early applications and trials will allow surgeons to work together with industy to continue to apply new robotic technology to enhance patient care,” noted James D. Luketich, M.D., head of thoracic surgery at the University of Pittsburgh's Lung Cancer
Center and principal investigator in the study.




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