When Greg Efner was diagnosed with blocked coronary arteries, his doctor scheduled him for a procedure to open them.
But instead of using the conventional approach, Dr. Zachary George employed a robot to perform the coronary angioplasty.
Blockages in coronary arteries can cause potentially fatal heart attacks. To open them, doctors typically guide a tiny balloon through the artery and then implant a mesh scaffold called a stent.
The procedure is performed thousands of times a day across the country. Former President George W. Bush had it done last August.
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During conventional angioplasty, doctors make a tiny incision in the wrist or groin, insert a catheter into the artery and guide it to the blockage using X-rays. On a monitor, they can see where they need to put the stent.
But with the CorPath Robotic-assisted PCI System, the doctor sits inside a console using joy sticks to control a telescopic lever-like arm that holds the sterile wire and stents while watching on computer monitors, said George, an interventional cardiologist with Greenville Health System. And at GHS, that console is 10 feet away from the patient.
“It’s a very different feeling,” he said. “It’s easier to place a stent when seated at a console than hunched over a patient.”
The main advantage to robotic surgery is its precision, which means improved accuracy, George said. It also enables physicians to more precisely measure stents to the blockages, he said.
“The robot allows for very precise stent placement, to one tenth of a millimeter scale,” he said. “Humans can’t do that.”
The lead-lined console also protects the doctor from potentially harmful X-ray radiation, George said.
“For the patient, the radiation level is minimal. But for the doctor doing seven or eight cases a day for years on end, that’s a huge amount of radiation,” he said. “It can cause cancer, leukemia, brain tumors, cataracts. This will lower radiation levels.”
Currently located in the operating room, the console will eventually be moved to a control room about 15 or 20 yards from the patient, George said.
The robotic surgery takes about the same time and has the same complication rate as conventional surgery, he said, with the most significant complications being a perforated artery or a heart attack, which occur in about one in 10,000 patients.
George said GHS is the first hospital in the state to use the robot. And it’s one of 11 hospitals in the U.S. so far to get the $470,000 technology, which was approved by the FDA in 2012, said Brett Prince, spokesman for the manufacturer, Corindus Vascular Robotics. GHS got an undisclosed discount for the device.
Earlier this month, Efner, an active 63-year-old retired salesman who bicycles 200 miles a week, became the first patient at GHS to have the procedure with the robot. And he didn’t mind being a guinea pig.
“I felt fine about it. I trusted the technology,” he said. “I said to the doctor, ‘So R2-D2 is going to be doing my operation.’ ”
Efner, who has a family history of heart disease, first saw his doctor after he began experiencing uncharacteristic shortness of breath and felt it was taking him longer to warm up.
“I thought it probably wasn’t anything serious,” said the Greenville man. “But now I’m extremely grateful I had the procedure.”
That’s because doctors found three of his arteries were blocked — two 80 percent and one 90 percent. He spent one night in the hospital after the procedure.
“It went well and I feel wonderful now,” he said. “I’ve even been on my bicycle already.”