When we think about a heart operation, it’s only natural to be concerned about the risks faced by the patient. What is overlooked is that the surgeon often faces risks in the operating theater as well. All the modern surgical paraphernalia may make cardiac medicine tremendously more advanced than it was a generation ago, but some of that equipment uses radiation that can be very dangerous to be around ... and surgeons are around it a lot. To help alleviate this, Corindus Vascular Robotics of Natick, Massachusetts, developed the CorPath 200 System. It’s a robot-assisted catheter system for unblocking arteries that allows cardiac surgeons to operate from a protective lead-lined cockpit while carrying out cardiac stent and balloon procedures.
Percutaneous Coronary Intervention (PCI) is a surgical cardiac procedure used to repair or prevent damage to the heart due to blocked or damaged heart arteries. It does this by means of either a stent or a balloon inserted at the end of a catheter into a major artery, usually in the leg, and navigated up to the heart. A stent is a mesh tube inserted into a failing artery to reinforce it like putting braces on the wall of a mine tunnel. A balloon is what is sounds like - it is moved to the site of a blockage in a heart artery and inflated to push the blockage aside and improve blood flow.
PCIs are very successful and common. Over 95,000 procedures a year are performed in the United States alone. The only problem is that the procedure requires the use of X-ray imagers to monitor and control the catheter’s movement and the rest of the operation. With the surgeon sitting next to the patient, that’s a lot of radiation exposure. There’s already a means of radiation protection in the form of heavy lead aprons and jackets, but they don’t provide full protection and can cause their own health problems due to their weight.
CorPath 200
CorPath 200 takes its cue from the nuclear power industry. If it’s too dangerous to be around radiation, then stay away and let a robot do the dirty work. CorPath is the first robotic-assisted system for stent and balloon procedures. It allows surgeons to operate from a lead-lined cockpit in the same room as the patient, yet remain protected against dangerous exposure to X-rays. In clinical trials, the cockpit reduced exposure of surgeons by 95 percent and there’s no need for traditional aprons
To operate the CorPath, the surgeon uses two joysticks, which control the catheter and other devices. There is also a bank of screens with which the surgeon can monitor the operation to enable extremely precise control of movements. However, the surgeon isn’t just running the robot like a video game. The system has a forced feedback feature that lets the surgeon “feel” the catheter as it’s inserted and moved through the artery.
Corindus announced on July 25, 2012 that the CorPath 200 received FDA 510(k) clearance to be used in PCI procedures.
“The FDA clearance of the CorPath System will truly change the way I am able to practice," said Joseph P. Carrozza, Jr. M.D., Chief of Cardiovascular Medicine at St. Elizabeth’s Medical Center in Boston. "As interventional cardiologists, we perform our procedures using X-ray guidance and are cognizant that throughout our careers we will be exposed to a high amount of radiation. In the past, we have relied on heavy lead aprons to protect us from radiation, but the physical stress of wearing these aprons can lead to back pain, fatigue and orthopedic injuries. Robot-assisted PCI procedures allow us to provide our patients with the highest quality of care working in an ergonomic position with robotic-assisted stent and balloon placements to restore blood flow.”
As to the future, Corindus is now looking at expanding the CorPath technology to deal with other vascular conditions, such as arterial problems in the arms and legs, neurological conditions and structural heart applications.
Doctors explain the CorPath 200 System in the video below.
Source: Corindus Vascular Robots