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University of Iowa News Release

June 11, 2004

UI Surgeons Announce First Repair Of Mitral Valve With Robot

Nancy Ryan, 59, of Madrid, Iowa wasn't motivated by the chance to be among a select group of medical pioneers. She just wanted to feel better.

"I couldn't do anything. I couldn't move off my couch. And that's no life," Ryan said.

Ryan's health problems were caused by a leaky mitral valve in her heart. She had concerns about undergoing traditional surgery to repair the valve, which involves making an incision that runs the length of the breastbone – dividing, or splitting, the bone – and a lengthy, often painful recovery.

Jeffrey Everett, M.D., a cardiothoracic surgeon at University of Iowa Hospitals and Clinics, offered Ryan an appealing alternative approach. He proposed making Ryan the first patient with a malfunctioning mitral valve at UI Hospitals and Clinics to benefit from the da Vinci robotic surgical system.

"The surgeon still does the same basic surgery," Everett explained. "The robotic system is really a tool that provides some advantages to the patient in terms of their reducing their amount of post-surgical discomfort and the length of their recovery time."

The surgical robot only requires an incision about two inches long plus several one-half inch incisions instead of the longer incision necessary for an open-heart technique. That means heart surgeons only have to spread two ribs and do not have to split the breastbone.

Ryan said she quickly felt "100 percent better." She reports that she experienced very little pain following the procedure, and that the shortness of breath is gone.

"All of the doctors, the nurses -- everyone here -- are great," Ryan said. "They have given me my life back."

Ryan returned home only four days after her surgery, which compares to the typical six- to seven-day hospital stay associated with the traditional technique. Even more impressively, the robotic approach enables patients to return to their normal activities weeks earlier than they are able to after receiving a large open incision.

Ryan's surgeon said the future should bring even more advances. Everett said he expects that eventually all mitral valve repairs will be done using the surgical robot, and that the next milestone will be using the technology to perform coronary artery bypass procedures.

"Anytime that we can give a quality result and have an improved outcome as far as recovery time and perhaps less pain and discomfort, it's certainly something that's exciting and something to look forward to in the future," Everett said.

The da Vinci system allows a surgeon to operate without actually putting his or her hands on the patient. Instead, after establishing access into the body cavity, the physician sits at a computer console that offers a three-dimensional view of the area to be treated with magnification up to 12 times that of normal vision. The surgeon uses special hand controls to manipulate long, narrow, specially hinged surgical instruments that are inserted through small incisions in the patient.

The remote-controlled instruments can be used in hard-to-reach areas and turned in ways that would be impossible with normal wrist dexterity. Altogether, these advantages allow the surgeon to work on a smaller scale and more precisely than traditional surgery. Information about the system can be viewed online at

The device currently is approved for use in surgeries in the abdomen, pelvis and chest. In addition, UI Hospitals and Clinics was the first medical center in Iowa to use the da Vinci system to perform urological procedures such as radical prostatectomy for removing a cancerous prostate and pyeloplasty for obstructed kidneys.

University of Iowa Health Care describes the partnership between the UI Roy J. and Lucille A. Carver College of Medicine and UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at

STORY SOURCE: Joint Office for Planning, Marketing and Communications, University of Iowa Health Care, 200 Hawkins Drive, Room 8798 JPP, Iowa City, Iowa 52242-1009.

MEDIA CONTACT: Tom Moore, 319-356-3945,