Skip to Content

Heart Hackers

September 1, 1998

To get their scalpels onto an ailing heart, surgeons usually have to crack open a patient’s rib cage-not a pretty sight, nor a procedure helpful to the healing process. That standard method may change soon: Using experimental robotic surgical instruments, physicians in France and Germany have performed a series of ground-breaking heart operations through dime-sized incisions, without any rib cracking at all. The advances culminated in late June when Alain Carpentier and Didier Loulmet of Broussais Hospital in Paris used the new techniques to perform a coronary artery bypass graft.

Minimally invasive surgery-which leaves patients with tiny scars and little post-operative pain-is already commonplace for procedures such as removing gallbladders. But more complex operations, such as heart surgery, have resisted minimally invasive methods, which generally require physicians to operate using awkward chopstick-like instruments. The French team of physicians was able to push the envelope thanks to a new system that gives joystick-wielding surgeons precise control over dexterous surgical instruments.

To use the system, originally developed at SRI International for battlefield telesurgery and now being commercialized by Intuitive Surgical of Mountain View, Calif., the surgeon sits at a console and peers into a close-up 3-D image of the patient’s heart. The image is captured by a scope inserted between the patient’s ribs through one of three small incisions. The remaining openings are for remote-controlled arms tipped by detachable instruments (choices include scissors, a suturing device and a grip) that swivel on an advanced wrist-like joint.

Intuitive’s Thierry Thaure, vice president for marketing, claims that surgeons find that the system’s robotic hands are even more precise than their own. They’re also steadier: The computer filters out unintended movements by the operator, such as shaking.

Not all heart surgeons are fans of “robosurgery,” however. Although current methods can mean a painful recovery for a patient and a large scar, they are tried-and-true. What’s more, in minimally invasive heart surgery, physicians must divert blood from the heart with a tricky system of catheters that can damage vessels. Thaure admits that getting doctors to try the novel setup may be challenging. They may, however, be persuaded to try it by their heart patients. The French doctors report that 24 hours after surgery their 69-year-old patient felt so good that he refused pain medication.

Intuitive Surgical plans to ask the Food and Drug Administration for permission to sell the minimally-invasive surgery system in the United States next year.

Keep Reading

Most Popular

computation concept
computation concept

How AI is reinventing what computers are

Three key ways artificial intelligence is changing what it means to compute.

still from Embodied Intelligence video
still from Embodied Intelligence video

These weird virtual creatures evolve their bodies to solve problems

They show how intelligence and body plans are closely linked—and could unlock AI for robots.

seeing is believing concept
seeing is believing concept

Our brains exist in a state of “controlled hallucination”

Three new books lay bare the weirdness of how our brains process the world around us.

We reviewed three at-home covid tests. The results were mixed.

Over-the-counter coronavirus tests are finally available in the US. Some are more accurate and easier to use than others.

Stay connected

Illustration by Rose WongIllustration by Rose Wong

Get the latest updates from
MIT Technology Review

Discover special offers, top stories, upcoming events, and more.

Thank you for submitting your email!

Explore more newsletters

It looks like something went wrong.

We’re having trouble saving your preferences. Try refreshing this page and updating them one more time. If you continue to get this message, reach out to us at customer-service@technologyreview.com with a list of newsletters you’d like to receive.