[Computer assisted open heart surgery. First case operated on with success]

The recent development of less invasive intracardiac surgery using small incisions and videoscopic techniques allowed an evaluation of the advantages and limitations of this new approach. Among the limitations was the increased difficulty of the surgical technique when using long instruments through small incisions and ports. We investigated whether computer assisted surgical instruments might bring a solution to this problem. Among the existing systems, we selected the Intuitive System because of two original features. It provides a stable, magnified, three dimensional view of the operating field at a console where the surgeon is seated to operate, and it uses computer assisted instruments having the same dexterity and range of motion as the hand. After 10 months of active work to adapt this system to intracardiac surgery, the first open heart operation using computer assisted instruments was carried out on a 52-year-old woman presenting an aneurysm and a large defect of the atrial septum. The patient was extubated 8 h after the operation, returned to her room 16 h later and was discharged from the hospital 8 d post-operatively with normal heart function and no residual shunt. This preliminary experience showed that computer assisted cardiac surgery is feasible and may open new and promising directions in open heart surgery.