Pioneer in robotic cardiac surgery completes milestone

Written By  Jimmy Ryals  on  6/23/2008 1:39:45 PM
Development and perfection of robotic-assisted mitral valve repair boon to patients

Greenville N.C., (June 20, 2008) - Dr. W. Randolph Chitwood Jr., a globally recognized cardiothoracic surgeon, today performed his 400th robotic-assisted mitral valve repair at Pitt County Memorial Hospital (PCMH), the teaching hospital for the Brody School of Medicine
at East Carolina University (ECU). Chitwood has performed more robotic-assisted mitral valve operations than any surgeon in the world.

Eleven cardiac surgeons from across the country observed the historic 400th robotic-assisted procedure while attending a two-day training program. Chitwood's robotic-assisted surgery
training center at the Brody School of Medicine at ECU was the first site in the U.S. to offer formal training in robotic-assisted mitral valve repair procedures.

"By integrating computer-enhanced technology with the surgeons' technical skills, robotic-assisted procedures enable surgeons to perform better surgery in a manner never before experienced," said Chitwood, president of the international Society of Thoracic Surgeons, director of the East Carolina Heart Institute and professor of cardiovascular surgery at the
Brody School of Medicine at ECU.

Chitwood is a pioneer in the development and expansion of robotic-assisted mitral valve repair surgery. In 1994, he began his pursuit to improve minimally invasive cardiac surgery, specifically the mitral valve repair procedure, and did the first minimally invasive mitral valve repair in North America in 1996 at PCMH.

Recognizing that endoscopic methods already used in surgery on other parts of the body could provide better visibility and access to the mitral valve, Chitwood devised a set of special instruments to simplify the repair procedure. In 1999, Chitwood applied his endoscopic expertise to robotic technology and contributed to the development of the da Vinci® Surgical System, a $1.5 million robotic surgical device made by Intuitive Surgical of Sunnyvale, Calif. In 2000, Chitwood used the da Vinci® System to perform the first complete, robotic-assisted mitral valve repair in North America as part of a multi-center, FDA-approved trial. It was the second such procedure in the world. In November 2002, the FDA approved the robotic-assisted mitral valve repair procedure, and to date, several thousand mitral valve repairs with da Vinci® have taken place around the world.

"Intuitive Surgical extends its congratulations to Dr. Chitwood and his colleagues on this historical occasion," said Lonnie Smith, chief executive officer of Intuitive Surgical Inc. "We appreciate Dr. Chitwood's seminal contributions to the advancement of robotically assisted
mitral valve repair, which have enabled us to extend the benefits of da Vinci cardiac surgery to patients worldwide."

Mitral valve repair produces far better outcomes than valve replacement, a once-prevalent surgical treatment for a leaky or narrowing mitral valve. An estimated 40,000 patients a year,
many under the age of 50, have operations on their mitral valve, the inflow valve for the left side of the heart. More than 90 percent of these cases require a sternotomy, or cracking of the sternum, and a 12-week recovery. With the da Vinci® Surgical System, surgeons make only three small incisions, scarring is minimal, infection rates are lower, and recovery time decreases dramatically, to two weeks.

"Not only is this technique far less invasive than traditional open-heart procedures, making it safer and far less painful for the patient, but repair of the valve, as opposed to replacement, has many additional benefits," Chitwood said.

Using the traditional valve replacement method, surgeons would replace a mitral valve with an "off-the-shelf" mechanical device. These mechanical valves require lifelong dependence on blood-thinning medications, and some require additional replacement surgery every 10 or 12 years.

This milestone signifies the future for robotic-assisted cardiac surgery, as surgeons are now being trained to perform this highly complex mitral valve repair procedure through Chitwood's program. With the da Vinci® Surgical System, surgeons insert two or three slim
instruments and a camera into the patient through tiny, dime-sized incisions. The camera allows the surgeon to view the operation in three dimensions and magnify the surgical field up to 10 times, while the other two arms hold surgical instruments manipulated by the surgeon. Seated at a computer console 10 to 15 feet from the operating table, the surgeon views the images on the console, controlling surgical instruments that mimic the movements of a human
wrist.

The techniques of mitral valve repair include: inserting a cloth-covered ring around the valve to bring two leaflets covering it into contact with each other, helping them close properly as the heart beats; removal of redundant/loose segments of the leaflets; and re-suspension of the leaflets. Chitwood has used the Cosgrove-Edwards Annuloplasty System, made by Edwards Lifesciences of Irvine, Calif., on all 400 robotic-assisted mitral valve procedures.
"We're proud to celebrate this milestone with Dr. Chitwood and his team, who are pioneers in the performance of robotic mitral valve repair and actively train others in the surgical community," said Donald E. Bobo, Jr., Edwards Lifesciences' corporate vice president, heart valve therapy. "The Cosgrove-Edwards band's adaptable design allows it to be implanted with both minimally invasive and robotic surgery techniques that many surgeons are training on and using in their practices today."

About East Carolina University's Brody School of Medicine
Since 1977, when the first class of 28 students enrolled in the four-year School of Medicine, East Carolina University's Brody School of Medicine has grown dramatically in its teaching, research and patient-care roles. Today, in its partnership with University Health Systems of Eastern Carolina and regional physicians, the school is the educational centerpiece of one of North Carolina's largest and most productive academic medical centers. In 1999, it was renamed the Brody School of Medicine at East Carolina University, in recognition of the
continuous support of the Brody family.
In 2009, the partnering East Carolina University and Pitt County Memorial Hospital will open the doors to the East Carolina Heart Institute, a new $210 million facility designed to strengthen the fight against cardiovascular disease, which accounts for 40 percent of all deaths in North Carolina. For more information, go to http://www.ecu.edu/med.

About University Health Systems of Eastern Carolina and Pitt County Memorial Hospital
UHS is a regional health system serving 29 counties in eastern North Carolina. The system includes Pitt County Memorial Hospital, a major academic medical center, and six community hospitals located throughout eastern North Carolina: Heritage Hospital in
Tarboro, Roanoke-Chowan Hospital in Ahoskie, Bertie Memorial Hospital in Windsor, Chowan Hospital in Edenton, The Outer Banks Hospital in Nags Head and Duplin General Hospital. Pitt County Memorial Hospital, a tertiary referral center, is one of only four academic medical centers in North Carolina and serves as the teaching hospital for the Brody School of Medicine at East Carolina University. For more information, go to http://www.uhseast.com.

About Intuitive Surgical Inc.
Intuitive SurgicalInc. is the global technology leader in robotic-assisted minimally invasive surgery (MIS). The Company's da Vinci® Surgical System offers surgeons superior 3D HD
visualization, enhanced dexterity, greater precision and ergonomic comfort for the optimal performance of MIS. Today, more than 860 da Vinci Systems are installed in hospitals worldwide. For more information, please visit www.intuitivesurgical.com.

About Edwards Lifesciences
Edwards Lifesciences is the global leader in the science of heart valves and hemodynamic monitoring. Headquartered in Irvine, Calif., Edwards treats advanced cardiovascular disease with its market-leading heart valve therapies, and critical care and vascular technologies. In
2008, Edwards celebrates 50 years of partnering with clinicians to develop life-saving innovations. The company's global brands, which are sold in approximately 100 countries, include CardioVations, Carpentier-Edwards, Cosgrove-Edwards, FloTrac, Fogarty, PERIMOUNT Magna and Swan-Ganz. Additional company information can be found at
http://www.edwards.com.

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