As reported in a recent edition of The Journal of Thoracic and Cardiovascular Surgery, physicians at the Columbia University College of Physicians and Surgeons have developed a minimally-invasive technique to implant breathing pacemakers using robotic assistance.

Surgical robot placing phrenic pacemaker.
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"Diaphragmatic pacing... is most commonly performed for patients with quadriplegia and central alveolar hypoventilation."Other indications include diaphragm paralysis and phrenic nerve damage.

The robotic system "consists of surgeon's control console along with a surgical arm unit that positions and manuevers detachable surgical instruments. From the console, the surgeon has a 3-dimensional, magnified, stereoscopic view of the operative field. The wrists of the robot mimic the motions made by the surgeon."

"Phrenic pacemakers were successfully implanted through an endoscopic approach with robotic assistance in all 6 patients...There were no intraoperative complications....There were no postoperative complications or deaths. Hospital stay was 1.7 ± 1.0 days"

"Insertion of a phrenic pacemaker through an endoscopic approach with robotic assistance minimizes surgical trauma. By avoiding multiple neck incisions, bilateral thoracotomies, or a sternotomy, an endoscopic approach is likely to yield a hastened postoperative recovery and improved quality of life."

Morgan JA, Morales DL, John R, Ginsburg ME, Kherani AR, Vigilance DW, Cheema FH, Smith CR Jr, Oz MC, Argenziano M. "Endoscopic, robotically assisted implantation of phrenic pacemakers." J Thorac Cardiovasc Surg. 2003 Aug;126(2):582-3.