Robot-assisted heart surgery

Dr Bob Banieghbal at Chris Hani Baragwanath Hospital in Soweto and Professor Benno Ure at his offices in Hannover, Germany, made use of the latest advancement in surgery - the telementoring system Socrates - to perform the laparoscopic surgery on a two-year-old child on Tuesday. While the operation itself is not unique, the technology used by Banieghbal has once again put South Africa on the medical map. According to Socrates suppliers, it was only the second time that two surgeons from different parts of the globe had used the technology to perform an operation together. Ure, sitting in his office in Germany, was able to advise Banieghbal on the best possible procedure, including where to cut, what to pull and where to stitch. Socrates allows surgeons to participate virtually in procedures taking place in distant operating rooms. How it works: Socrates links surgeons in the operating room with colleagues anywhere in the world. A voice-controlled robotic arm (Aesop) positions and holds an endoscope (a minute camera used to view internal organs) which is inserted into the patient via the navel.Two further incisions are made (the positioning depends on the type of surgery) in which miniature medical instruments are inserted. The surgeon physically present has control over the instruments while both surgeons have control over Aesop, to enable them to have the best possible view of the area being operated on. The surgeons are in contact with each other via TV screens and ISDN telephone lines. The virtual surgeon has a monitor that shows him exactly what is being done, as well as a computer mouse with which he can indicate to the surgeon exactly where to cut or suture. Markings made by the virtual surgeon can be seen on a monitor. Socrates makes it possible for specially trained surgeons to become interactively present wherever needed. Added to this, physicians in rural and remote areas can consult with specialists in emergency situations. The equipment is on short loan to Bara, but Banieghbal is working on ensuring that the hospital keeps it for at least a year. The equipment could cost anything from R600 000 to R1,2-million, he added.