HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Francis Robicsek Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Robicsek, F. Search for Related Content PubMed Articles by Robicsek, F. Related Collections Minimally invasive surgery

J Thorac Cardiovasc Surg 2008;136:238
© 2008 The American Association for Thoracic Surgery

Letter to the Editor

Reply to the editor:

Carolinas Heart and Vascular Institute, Carolinas Medical Center, Charlotte, NC

I appreciate the earnest comments of my colleagues.

Evidently, we see the potentials of telerobotics in a different perspective. They believe not only that robotics is the future of cardiac surgery, but also that the future is already here! I respectfully disagree.

They kindly recall my role as an "innovator." With my 12 patents (the last one in 2008), I would not deny it. However, I was also the one who, as the invited discussant to the first lecture of Andreas Gruntzig, stated that coronary balloon angioplasty will have an unacceptable recurrence rate, and I also proved soon after its introduction that aortic balloon valvuloplasty will be a disaster. To be an innovator means not to "change" but to change toward the better.

In today's era of evidence-based medicine, the rules of innovation are strict. Informed consent is not a nebulous concept anymore. The margins of clinic and industry are better defined. Novel methods must undergo intense scrutiny not only from a clinical standpoint but also from an ethical and economic aspect. Because results of telerobotics might have reached, but certainly did not exceed, those obtained with simpler minimally invasive methods and because telerobotics has definite marketing undertones, with its costs now exceeding a billion dollars in equipment alone, we are obligated to ask specific questions. In my editorial I was asking these questions with an open mind but also with a healthy dose of old-fashioned skepticism.

The closing words of my editorial were these:

Elements of robotics could indeed be part of the future technology of minimally invasive cardiac interventions. The proper way to proceed with this endeavor however, is not to flood the market with billions of dollars worth of hardware, most of it already obsolete, but to limit their use to a few centers with sincere professional interest, until in well-controlled trials, the technology proves itself economically sound, as well as clinically superior to that which we already have today.

The proof is on you, gentlemen.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Francis Robicsek Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Robicsek, F. Search for Related Content PubMed Articles by Robicsek, F. Related Collections Minimally invasive surgery