When performing open heart surgery, there’s this pesky thing called the sternum between you and your pulsating target. The tried-and-true solution to this conundrum is to saw that baby open, which is brutal if you’re watching, and incredibly fun if you’re doing. Once finished with the procedure, the two halves of the chest the surgeon has created are tied back together with either wires or cables, which is a relatively secure but not a perfect fixation.
There are a couple of issues that this practice poses. One is post-operative pain, as any movement or cough causes the two flat bony surface to rub back and forth despite the wire fixation. Another is the risk of a sternal wound infection, which can lead to the dreaded mediastinitis. Mediastinitis is truly a horrendous complication and requires the removal of the sternum itself.
To address these issues, novoSurge has developed their robotic Structured Sternotomy System. The system uses x-rays and ultrasounds of the chest to automatically design a sinusoidally shaped incision path. The curved shape, as opposed to the straight line currently favored by cardiothoracic surgeons, theoretically provides more stability once the sternotomy is repaired, hopefully leading to less of the problems listed above. Once the template is set, a robotic ultrasonic blade controlled remotely by the surgeon makes the incision. The use of an ultrasonic blade as opposed to a saw is meant to decrease the localized soft tissue damage, which is purported to lead to quicker healing by the manufacturer.
Unfortunately, novoSurg doesn’t have any studies available showing the efficacy of their technology. While promising, the costs could be prohibitive and it could increase the length of an already lengthy and risky procedure. Hopefully, they can show significant benefits down the road to justify the costs. For now, some surgeons have taken to using less precise curved sternotomies incisions using the standard saw and a little elbow grease.
Novosurge technology page…
Video below the fold demonstrating how the system is operated:
(hat tip: Globes)