Enabling medical robotics for the next generation of minimally invasive procedures: Minimally invasive cardiac surgery with single port access

Minimally invasive cardiac surgery (MICS) is an evolving strategy aimed at delivering the desired form of cardiovascular therapy with the least change in homeostasis, ideally matching the same degree of invasiveness of percutaneous cardiac interventions. Cardiac surgery is different from other surgical procedures because the large sternotomy incision required to access the heart requires general endotracheal anesthesia (GETA) and the heart-lung machine that is required for open-heart surgery (e.g. valve repair) adds further morbidity. We have developed a novel, highly articulated robotic surgical system (CardioARM) to enable minimally invasive intrapericardial therapeutic delivery through a subxiphoid approach. The CardioARM is a robotic surgical system consisting of serially connected rigid cylindrical links housing flexible working ports through which catheter-based tools for therapy and imaging can be advanced. The CardioARM is controlled via a computer-driven user interface which is operated outside of the operative field. We believe single port access to be key to the success of the CardioARM. We have performed preliminary proof of concept studies in a porcine preparation by performing epicardial ablation.