British surgeon warns against robotics for heart operations

Risks in the spotlight as Professor Stephen Westaby said he would refuse to have such an operation

DUBAI, UNITED ARAB EMIRATES,  JUNE 17, 2013. Working moms. Dr. Houriya Kazim BSc, MPH, MB BCh, FRCS, Medical Director and Specialist Breast Surgeon, an Emirati and the country's first female surgeon at work on a surgery at the Dubai London Speciailty Hosptial on Beach rd.  Freelancer is Rachel Lewis. (ANTONIE ROBERTSON / The National)
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A leading surgeon has warned against the use of robotics in heart surgery following the death of a patient in a pioneering heart operation that was billed as the first of its kind in Britain.

Professor Stephen Westaby, a heart surgeon at John Radcliffe Hospital in Oxford, said that greater controls over the use of robotic heart surgery were needed and that he himself would refuse such an operation.

“It is impossible, in my view, to step into an operating theatre with a robot as your assistant and hope to do it well first time, it simply won’t happen,” he told British radio.

“There certainly should be guidelines introduced,” he added.

His comments came following an inquest into the death of Stephen Pettitt, 69, who died almost three years ago during robotic mitral valve surgery.

Mr Pettitt was the first person in Britain to undergo such an operation, but died during it from multiple organ failure.

The inquest revealed that the surgeon had no hands-on training with the robot prior to the operation. The coroner added that Mr Pettitt had just a 1-2 per cent chance of dying had the operation been carried out conventionally.

Asked if he himself would opt for such an operation, the Mr Westaby said “No”, warning such operations were being carried out without sufficient practice.

“Every time you stop a heart and try and restart it, it does risk that patient’s life and the smallest of mistakes can cascade into disaster.”

“I have several colleagues in this country and many abroad who are very adept with operating with these minimally invasive techniques with and without a robot, but it does take a lot of training,” he added.

“If you are going to introduce a new and allegedly innovative way of doing a heart operation, you need to be well practiced and understand that you must do it as safely as a conventional operation.”“I think in the first instance, a surgeon who wants to do robotic surgery on a heart should go to an established centre that does it every single day, they have to learn from a master and then when they try to introduce the techniques back here in the National Health Service, the mentor has to come back and remain in the operating theatre to make sure that first cases go safely.”


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He warned that the alleged advantages of such operations were overplayed.

“In robotics, the surgery is done through small holes, and essentially for heart surgery, that is the only advantage, small incisions and allegedly a more rapid recovery, but the more rapid recovery doesn’t happen because of the other issues.”