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Open heart surgery without an open chestOn November 21, 2002, Aurora St. Luke's Medical Center performed the Midwest's first closed-chest coronary artery bypass surgery. The historic feat has been compared to working on a car engine without lifting the hood. Some surgeons, such as Daniel O'Hair, who performed the procedure, say they believe use of such devices is the future of cardiac surgery. "Having gone through it, it's a very practical operation," O'Hair said. "I don't think there is anything that stretches the limits of safety." After spending two years preparing for Thursday's operation, O'Hair said he expects to soon be doing up to two of the procedures a month. The surgery is done using the da Vinci robotic system, which uses robotic arms that are inserted in the chest via four holes each about the width of a pencil. The system technically is not a robot because its arms are operated in real time by the surgeon. The surgeon's fingers are placed in rings and connected to a master controller. When the surgeon's fingers move, the device's arms move. Another arm is used to operate a three-dimensional camera. Heart surgery usually requires a saw to cut through the sternum to create a foot-long incision. Because the surgery was done without having to saw through the patient's breastbone, he is expected to recover from the operation much quicker, is likely to be discharged sooner and will be able to return to normal activities in a fraction of the time. U.S surgeons have used the da Vinci device to do nearly 25 operations to repair the hearts of patients with atrial septal defect, a condition in which people are born with an opening between the heart's two upper chambers. The condition is repaired with a patch or by sewing the hole closed. In addition, about 15 closed-chest bypass operations, including the one at St. Luke's, have been done in the last year.
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