Thursday , October 6 2022

The lessons left by the death of the patient undergoing cardiac robotic surgery



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Stephen Pettitt was retired music teacher, 69, who had a heart problem.

The required surgery had a chance & # 39; 98 or 99% & # 39; success. This, assuming that the surgeons performing the operation were human.

But the operation has become Pettitt carried out by a robot and the patient died.

Pettitt, who was operating in 2015 at the Freeman Hospital in Newcastle, England, was The first patient in the United Kingdom passed the pioneering treatment & # 39; robotic cardiac surgery.

And as the investigation of the causes of her death concludes, "there is a risk that other deaths occurring" with & # 39; this type of & # 39; procedure.

The program & # 39; robotic cardiac surgery in England was suspended after the death of & # 39; Stephen Pettitt.

Surgery to & # 39; robot

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In robotic surgery, using miniaturized surgical instruments can be inserted into & # 39; several small incisions in the body.

Complications

In the verdict of the investigation, the forensic doctor Karen Dilks indicated that the death was "a direct consequence of the operation and its complications".

"Mr. Pettitt died due to complications in & # 39; surgery to treat mitral valve disease and, in part, because the operation was carried out by & # 39; robotic assistance."

These complications included discussions among surgeons who were operating the robot and deficiencies in the training of surgeons who performed the procedure.

The verdict raises important questions about the increasing dependence of humans on robotic surgery.

robot

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The robotic surgery used b & # 39; high rates of & # 39; success since the early 2000s in & # 39; & # 39 thousands; hospitals worldwide.

The robotic surgery is a type of & # 39; minimally invasive surgery. That is, instead of operating on the patient to carry large incisions, using miniaturized surgical instruments can be inserted into & # 39; several small incisions in the body.

What is done is to place these miniature surgical instruments in & # 39; robotic arms, so that The surgeon can & # 39; & # 39 performs a series; precision movements.

These systems used by & # 39; high rates of & # 39; success since the early 2000s in & # 39; & # 39 thousands; hospitals around the world, b & # 39; in particular for hysterectomies and prostate extractions.

F & # 39; in recent years, some hospitals have started using it in & # 39; heart valve repair interval, such as operation which subjected the English patient.

Surgeons trained

As Dr Patrick Finlay, president of the British Association of Biomedical Engineering, told the BBC, the use of & # 39; robots proved, over the years, to be extremely safe, as long as hands are trained to manage.

"Placing & # 39; robot f & # 39; surgical procedure requires following a series of & # 39; very strong measures, it is necessary to pass several regulations and tests to ensure that the robot is safe," says expert .

"It also requires that the handset manage them is competent and that need training"

"Training is very simple, but can & # 39; use one of these robots b & # 39; safe way requires training not only & # 39; the things you expect to happen but also & # 39 ; what is not expected to occur, in addition to training for the specific procedure will perform "

robot

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It requires a lot of training and practice before he can surgeon & # 39; perform robotic surgery.

Professor Stephen Westaby, a heart surgeon at John Radcliffe Hospital in & # 39; Oxford, England, and one of the most experienced specialists in the country, agrees.

"Robotic systems have been used by & # 39; safe way in all kinds & # 39; surgeries for many years," says the expert the BBC.

"But in cardiac surgery there is a slight difference: this is done against the clock, because to see the party & # 39; inside the heart and operate on the patient wants to stop the heart and connect the patient & # 39; heart lung machine to help in blood circulation. "

"Furthermore, the cardiac arrest done by & # 39; solution called kardjoplegia, to protect the heart."

But as the expert says, all this has the disadvantage of time. As more being connected to & # 39; engine, more damage can & # 39; sustains the heart, and more with the blood circulation is interrupted, it is more difficult to get & # 39; start the heart.

"Then use & # 39; robotics in cardiac surgery has advantages because only small incisions required by the procedure and because of the rapid recovery properly," says the Professor Westaby.

"But that faster recovery depends on all the factors I mentioned before", he adds.

robotics surgery

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Seeks to establish guidelines include the use of & # 39; experts supervisors doctors – offering advice during surgical procedures.

human error

What caused the most controversy in the English patient died if it was revealed that do not exist in & # 39; this country Guidelines established for the use of & # 39; robots in the operating room.

As indicated in the forensic investigation, including policy shall be determined using & # 39; doctors expert supervisors – offering advice during the new procedures.

The Coroner, Karen Dilks, indicated in his research findings that "failure & # 39; & # 39 points; reference" in training for new treatments and interventions.

The investigation indicated that the surgeon who ordered the operation & # 39; Pettitt He had personal training to use the robot.

He added that & # 39; the patient was likely to continue & # 39; alive if he had undergone open heart surgery, which would only 1% or 2% chance of death.

But this means that the robots m & # 39; & # 39 be used in, some cardiac surgeries?

"No, not everything", says Professor Westaby. "There are many colleagues both in & # 39; this country and abroad who are experts in & # 39; these operations. But To get the & # 39; of & # 39; most training needs. "

"If you are going niddaħħlu new and innovative way to perform heart operations, we need to do a lot of practice", says the expert.


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